RESUMO
Tracheostomy, long-term mechanical ventilation, spinal deformaties are factors that contribute in patients with neuromuscular disorders to the development of an erosion of the tracheal wall and subsequent formation of a tracheo-innominate artery fistula. This condition is fatal unless promptly treated by exclusion of the innominate artery, which is often performed under desperate circumstances. We electively adopted a preventive ligation of the innominate artery in patients at risk for trachea-innominate artery fistula (TIF). We present seven patients with neuromuscular disorders who underwent preventive ligation of the innominate artery. All seven patients survived.
Assuntos
Tronco Braquiocefálico/cirurgia , Doenças Neuromusculares/cirurgia , Adulto , Fístula/cirurgia , Humanos , Ligadura/métodos , Doenças da Traqueia/cirurgiaRESUMO
STUDY OBJECTIVES: Evaluation of different types of tracheostomy tubes in patients with neuromuscular disorders. DESIGN: Review of past charts of 49 patients with DMD. SETTING: Intensive care unit of Children's Hospital-Bambino Gesù Rome-Palidoro, Italy CONCLUSIONS: Our findings favour the use of flexible tracheostomy tubes in reducing the risk of developing tracheal haemorrhages.
Assuntos
Brônquios/lesões , Hemorragia/etiologia , Distrofias Musculares/complicações , Traqueia/lesões , Traqueostomia/efeitos adversos , Adulto , Broncoscópios , Desenho de Equipamento , Hemorragia/prevenção & controle , Humanos , Doença Iatrogênica/prevenção & controle , Distrofias Musculares/terapia , Maleabilidade , Estudos Retrospectivos , Traqueostomia/instrumentaçãoRESUMO
We present a case of a 16-month old previously healthy child who was hospitalized because of an acute respiratory insufficiency most likely caused by a viral infection and who then developed a severe acute quadriplegic myopathy (AQM). Initial clinical symptoms were respiratory acidosis, dypnea, intense wheezing, and deterioration of the level of consciousness, which required orotracheal intubation and mechanical ventilation. We administered neuromuscular blocking agents, corticosteroids, and antibiotics. After 9 days the clinical picture improved. An attempt to wean from the ventilator failed. We diagnosed AQM. This paper discusses AQM and its clinical importance.
