A proposed new method of hemostasis for erosive-hemorrhagic complications of the trachea and bronchi

Abstract

Ventilator-associated complications are the most frequent ones that prevent the recovery of intensive care patients. This study aimed to evaluate the effectiveness of the endoscopic treatment of acute hemorrhagic lesions of the tracheobronchial tree in patients with ventilator-associated tracheobronchitis. A total of 5 patients (22.4±3.3 mean age, 18 to 36 years) with prolonged mechanical ventilation (>48 hours) in the resuscitation and intensive care unit were monitored. The diagnosis of ventilator-associated tracheobronchitis was established on the basis of clinical signs, radiological and microbiological criteria. Fine-dispersed powder with hemostatic properties (HEMOBEN) was used as a hemostatic agent when applying the method. A morphometric study noted that ventilator-associated tracheobronchitis is accompanied by a pronounced lymphoid-neutrophilic infiltration of the tracheal and bronchial mucosa (signs of diffuse catarrhal inflammation of varying degrees and erosive deforming endobronchitis are verified), and in a complicated course with the presence of a purulent-inflammatory and erosive-hemorrhagic component with its vascularization and metaplastic changes and violations of the integrity of the epithelial lining also leads to a violation of the integrity of tissues due to destruction and necrosis. Hence, a method has been developed to stop bleeding in case of mucosal damage by local application of HEMOBEN, which allows us to quickly cover the bleeding surface with an adequate hemostatic effect.