Published online Oct 16, 2021. doi: 10.12998/wjcc.v9.i29.8915
Peer-review started: June 19, 2021
First decision: July 5, 2021
Revised: July 17, 2021
Accepted: August 6, 2021
Article in press: August 6, 2021
Published online: October 16, 2021
Processing time: 117 Days and 21.3 Hours
Trauma is one of the leading causes of death in the pediatric population. Bronchial rupture is rare, but there are potentially severe complications. Establishing and maintaining a patent airway is the key issue in patients with bronchial rupture. Here we describe an innovative method for maintaining a patent airway.
A 3-year-old boy fell from the seventh floor. Oxygenation worsened rapidly with pulse oxygen saturation decreasing below 60%, as his heart rate dropped. Persistent pneumothorax was observed with insertion of the chest tube. Fiberoptic bronchoscopy was performed, which confirmed the diagnosis of bronchial rupture. A modified tracheal tube was inserted under the guidance of a fiberoptic bronchoscope. Pulse oxygen saturation improved from 60% to 90%. Twelve days after admission, right upper lobectomy was performed using bronchial stump suture by video-assisted thoracic surgery without complications. A follow-up chest radiograph showed good recovery. The child was discharged from hospital three months after admission.
A modified tracheal tube could be selected to ensure a patent airway and adequate ventilation in patients with bronchial rupture.
Core Tip: Tracheal intubation for traumatic bronchial rupture is difficult and complex. A modified tracheal intubation is a simple method to establish and maintain a patent airway for respiratory support in traumatic bronchial rupture. We treated a 3-year-old boy successfully using a modified tracheal tube which was inserted under the guidance of a fiberoptic bronchoscope.