Abstract
The incidence, aetiology and long term outcomes of laryngotracheal complications secondary to Tracheostomy insertion in patients ventilated for COVID-19 critical Illness are currently unknown. We report a single case from our COVID-19 institutional series who developed early subglottic stenosis and subsequent traceomalacia preventing permanent tracheostomy removal despite three decannulation attempts. We consider the known risk factors for laryngotracheal complications following endotracheal intubation and tracheostomy, in combination with the potential impact of COVID-19 pathological features. Clinical indicators from the case presentation are explored in relation to the early identification of tracheomalacia in the patient with Tracheostomy, and the mechanisms underlying these presenting features are proposed.
Highlights
The COVID-19 pandemic in the United Kingdom (UK) resulted in a large number of patients dependant on mechanical ventilation who subsequently required tracheostomy insertion
We report a single case from our institutional series who experienced more than one tracheal complication secondary to Tracheostomy insertion following COVID-19 critical illness and subsequently failed to decannulate over several attempts
In Table tolerance to one way valve (OWV) in the supine posture was limited (10secs) and 1 we compare the known risk factors for laryngotracheal complications associated with desaturation and increased work of breathing in with our case, and suggest that these comparison to OWV application in the upright posture which was features may have predisposed complications without the additional consistently tolerated
Summary
Jake Causon 1, Robyn Cary 2 and Amanda Jane Thomas3* 1Highly Specialist Physiotherapist, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom. 2Highly Specialist Speech and Language Therapist, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom. 3Clinical Specialist Physiotherapist, Critical Care Outreach Team, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom. Jake Causon 1, Robyn Cary 2 and Amanda Jane Thomas3* 1Highly Specialist Physiotherapist, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom. Received date: June 14, 2021: Accepted date: August 24 2021: Published date: September 08, 2021
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