Abstract

Tracheal ruptures are one of the life-threatening situations in critical care unit and can be formed after trauma, intubation, tracheotomy, bronchoscopy or spontaneously. Significant risk factors for tracheal rupture include urgent intubation, use of stilet, high cuff pressure, recurrent intubation attempts, double lumen endotracheal tubes, very thick endotracheal tubes, female gender, short height, older age, tracheomalacia, tracheal stenosis, congenital tracheal abnormalities and chronic steroid therapy. Among these risk factors, corticosteroids can cause rupture by inhibiting collagen synthesis and reducing connective tissue stability. In this case report, a case with spontaneous recurrent tracheal rupture was defined and the underlying mechanisms and therapeutic approach to this complication that could be seen in patients using chronic steroids were discussed.

Keywords: Tracheal rupture, corticosteroid, treatment

References

  1. Kumar S, Goel S, Bhalla AS. Spontaneous tracheal rupture in a case of interstitial lung disease (ILD): a cese report. J Clin Res 2015;9:1-2.
  2. Paraschiv M. Iatrogenic tracheobronchial rupture. J Med Life 2014;15:343-8.
  3. Farooqui AM, Mbarushimana S, Faheem M. Unusual case of acute tracheal injury complicated by application of positive end expiratory pressure (PEEP). BMJ Case Rep 2014:2014.
  4. Gorosh LR, Ingaramo O, Nelson D, Vohra M, Ciccolo ML. Spontaneous tracheal rupture: a case report. J Emerg Med 2014;46:31-3.
  5. Rousié C, Van Damme H, Radermecker MA, Reginster P, Tecqmenne C, Limet R. Spontaneous tracheal rupture: a case report. Acta Chir Belg 2004;104:204-8.
  6. Tsunezuka Y, Sato H, Hiranuma C, Ishikawa N, Oda M, Watanabe G. Spontaneous tracheal rupture associated with acquired tracheobronchomalacia. Ann Thorac Cardiovasc Surg 2003;9:394-6.
  7. Stevens MS, Mullis TC, Carron JD. Spontaneous tracheal rupture caused by vomiting. Am J Otolaryngol 2010;31:276-8.
  8. Zettl R, Waydhas C, Biberthaler P, Lewan U, Riedl V, Duswald K, et al. Nonsurgical treatment of a severe tracheal rupture after endotracheal intubation. Crit Care Med 1999;27:661-3.
  9. Rousié C, Van Damme H, Radermecker MA, Reginster P, Tecqmenne C, Limet R.
  10. Spontaneous Tracheal Rupture : a Case Report. Acta Chir Belg 2004;104:204-8.
  11. Liu J, Zhang M, Niu C, Luo Z, Dai J, Wang L, et al. Dexamethasone inhibits repair of human airway epithelial cells mediated by glucocorticoid induced leucine zipper. PLoS One 2013;8:e60705.
  12. Buchman AL. Side effects of corticosteroid therapy. J Clin Gastroenterol 2001;33:289-94.
  13. Schakman O, Gilson H, Thissen JP. Mechanisms of glucocorticoid-induced myopathy. J Endocrinol 2008;197:1-10.
  14. Borasio P, Ardissone F, Chiampo G. Post-intubation tracheal rupture. A report on ten cases. Eur J Cardiothorac Surg 1997;12:98-100.
  15. Wagner A, Roeggla M, Hirschl MM, Roeggla G, Schreiber W, Sterz F. Tracheal rupture after emergency intubation during cardiopulmonary resuscitation. Resuscitation 1995;30:263-6.
  16. Gries CJ, Pierson DJ. Tracheal rupture resulting in life-threating subcutaneous emphysema. Respir Care 2007;52:191-5.
  17. Gabor S, Renner H, Pinter H, Sankin O, Maier A, Tomaselli F, et al. Indications for surgery in tracheobronchial ruptures. Eur J Cardiothorac Surg 2001;20:399-404.

Copyright and license

Copyright © 2019 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite?

1.
İnal MT, Memiş D, Tunçbilek N, Tek Ş, Uyar AŞ, Budak H, et al. Spontaneous Repetitive Tracheal Rupture. Turk J Intensive Care. 2019;17(1):54-57. https://doi.org/10.4274/tybd.galenos.2017.92905