Fractured Tracheostomy Tube Research Articles

From Respiratory Distress to Spontaneous Relief: The Case of a Fractured Tracheostomy Tube

Tracheostomy is a widely accepted procedure for maintaining airway patency, but it can lead to both early and late complications. While rare, tracheostomy tube (TT) fracture is a serious complication that may occur, particularly in patients who have used the device for an extended period. We report the case of a patient with a long-term metal tracheostomy tube who presented to the emergency department with acute dyspnea due to the fragmentation and displacement of the TT into the tracheobronchial tree. This unusual event prompted urgent intervention for foreign body removal. After stabilization, a chest X-ray confirmed the position of the fractured tube, and although bronchoscopic removal was planned, the patient was able to expel the broken tube spontaneously following a vigorous coughing effort. This case highlights the importance of careful monitoring in long-term tracheostomy patients, as well as the potential risks associated with prolonged use of tracheostomy tubes. Regular cleaning, routine surveillance, and scheduled replacement of the tube are critical preventive measures to reduce the risk of such complications.

Aspiration of Fractured Tracheostomy Tube in a Prone Positioned COVID-19 Patient: A Case Report and Review of the Literature.

A 61-year-old male patient diagnosed with Coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS) was managed with tracheostomy and intermittent prone positioning in the intensive care unit. After a sudden deterioration, examination of tracheostomy tube (TT) and X-ray of the chest revealed that he had aspirated the fractured TT. The fractured tube was removed through the tracheostomy stoma using a rigid ventilating bronchoscope and forceps. Prone positioning is a beneficial postural therapy capable of improving patient oxygenation. However, it has some complications, like unplanned extubation and facial tissue injury. Percutaneous tracheostomy is also a valuable and safe procedure and has been increasingly performed in critical care patients, including those who suffer from COVID-19 ARDS. Fractures and aspiration of a tracheostomy tube can occur anytime after tracheostomy. We think prone positioning may contribute to the rupture and aspiration of the tracheostomy tube in this study.

Aspiration of a fractured tracheostomy tube, a rare complication of tracheotomy: the factors involved in this incident and literature review

<p class="abstract">Tracheostomy is executed routinely for several indications. It is a safe and life-saving procedure. In some cases, the tracheostomy tube has to be maintained for a long duration. We report a rare case of aspiration of a fractured tracheostomy tube. In the light of the literature, we reported the various factors leading to complications of tracheotomy. A 5-year-old boy, presenting to the emergency department for aspiration of a fractured tracheostomy tube accidentally during a cleaning process by his mother. On clinical examination, the patient was slightly symptomatic. A flexible bronchoscopy was made which objectified the presence of the cannula in the trachea, an additional chest X-ray was taken, which revealed the aspirated tracheostomy tube in the trachea and right main bronchus. Extraction was done by rigid bronchoscopy under general anesthesia. The postoperative course of the patient remain uneventful. In order to reduce the potentially fatal complications of the tracheotomy, it is necessary to insist on a regular medical follow-up.</p>

An Unusual Case of Fractured Tracheostomy Tube as a Foreign Body in Right Main Bronchus: A Case Report

An Unusual Case of Fractured Tracheostomy Tube as a Foreign Body in Right Main Bronchus: A Case Report

Fractured Tracheostomy Tube Migrating into the Tracheobronchial Tree: A Rare Complication

Tracheostomy is a life saving procedure and many patients are discharged with permanent tracheostomy tubes. We report the rare occurrence of a fractured tracheostomy tube migrating into the tracheobronchial tree and highlight the clinical manifestations of this uncommon complication that carries the potential risk of fatal respiratory obstruction.

Fractured Tracheostomy Tubes into the Tracheobronchial Tree

Fractured Tracheostomy Tubes into the Tracheobronchial Tree

Factors Associated with Fracture and Migration of Tracheostomy Tube into Trachea in Children: A Case Series.

IntroductionTracheostomy is done to bypass the obstructed upper airway. Rare complication of this procedure is the fracture of the tube. Early identification and management of this condition is a great challenge to an otolaryngologist. To study the factors associated with the fracture and migration of tracheostomy tube into tracheobronchial tree in paediatric age group.Materials and Methods:This study is a case series study conducted on children with a diagnosis of fractured tracheostomy tube presenting as a foreign body airway over five years duration. Data regarding the possible patient and tube factors responsible for the condition were collected and analysed. Results:Total 11 patients (males-5 and females-6, average age-10.18 years, range 1-15 years) wearing tracheostomy tube for an average period of 2 years (range 3 months-8 years) were included in the study. Aspirated tubes were Jackson’s metallic inner tube, Romson polyvinyl chloride plastic tube and Fuller’s outer tube flange in 5 (45.5%), 4 (36.4%) and 2 (18.1%) patients respectively. The most common fracture site was at the junction between tube and neck plate (90.9%). The most common causes for fracture tube were prolonged use in 10 cases (90.9%), stomal narrowing in 9 cases (81.8%), and infection with peri-stomal granulation tissue in 9 cases (81.8%). Conclusion:A fractured tracheostomy tube is a rare but preventable late complication of tracheostomy. Appropriate training about proper tracheostomy care, timely check-up of tracheostomy tube for signs of wear and tear, scheduled replacement, regular follow up and awareness may prevention this complication.

Fractured tracheostomy tube: an unforeseen complication

Fractured tracheostomy tube: an unforeseen complication

Aspiration of a Fractured Tracheostomy Tube in a Patient with Pre-existing Airway Compromise

Aspiration of a Fractured Tracheostomy Tube in a Patient with Pre-existing Airway Compromise

Fractured tracheostomy tube posted for bronchoscopic removal: An anesthetic challenge.

Fractured tracheostomy tube posted for bronchoscopic removal: An anesthetic challenge.

When a Safety-Valve Became a Ticking Time-Bomb: Fractured Tracheostomy Tube as a Tracheobronchial Foreign Body in a Child

AbstractTracheostomy Tube care is a part of respiratory rehabilitation in acquired brain injury but just tracheostomy tube insertion is not enough. Checking for Pre-requisites including manufacturing details, and regular follow – up is important. Here we present a rare case of fracturing of the tracheostomy tube in a traumatic brain injury which was managed timely.

Metallic Tracheostomy Tube Fracture-Case Report with Review of Literature

Tracheostomy is a safe common airway procedure for life support with mortality rate of less than 5%.Tracheostomy tube fracture resulting in airway obstruction and respiratory distress is extremely rare needing timely recognition and prompt action. We report the case of a 70 years old man whose tracheostomy tube fractured and became lodged in mid trachea resulting in respiratory distress. Fiberoptic bronchoscopy was done and the foreign body (fractured tracheostomy tube) was removed giving immediate relief to the patient. Review of literature along with proposed recommendations are made for tracheostomy care to help and prevent similar complications in patients with an indwelling tracheostomy tube.

Fractured and migrated tracheostomy tube in the tracheobronchial tree

ObjectiveTo study the clinical presentation and management of fractured tracheostomy tube (FTT) presenting as tracheobronchial foreign body (FB) in children. MethodsA retrospective chart review of children with a diagnosis of FTT, FB in tracheobronchial tree was carried out. Data regarding the patients’ demographic details, diagnosis, clinical presentation and management were noted and analyzed. ResultsTotal 8 cases (males 3 and females 5, average age 8.8 years, range 1–15 years) wearing tracheostomy tube for an average period of 2 years (range 3 months–4 years) were found. Indications for tracheostomy were bilateral abductor palsy, subglottic stenosis and congenital subglottic hemangioma in 4 (50%), 3 (37.5%) and 1 (12.5%) cases, respectively. Classical triad of FB aspiration (coughing/choking, wheezing and reduced breath sounds) was present in 6 (75%) patients.Aspirated FTTs were Jackson’s metallic inner tube, Romson’s polyvinyl chloride plastic tube and Fuller’s outer tube flange in 4 (50%), 3 (37.5%) and 1 (12.5%) respectively. The most common fracture site was at the junction between tube and neck plates {in 7 (87.5%) children}. Sites of lodgment of FTT were right bronchus, trachea and both trachea and left bronchus in 5 (62.5%), 2 (25%) and 1 (12.5%) cases, respectively.FTTs were retrieved by transtracheostomal rigid bronchoscopy and exploring the tracheostomal wound in 7 cases and 1 case, respectively. ConclusionThough FTT presenting as pediatric tracheobronchial FB is rare, it should be considered in differential diagnosis in a tracheostomised child with respiratory distress. When diagnosed, FTT removal is best done using a rigid bronchoscope through the tracheal stoma.

Aerodigestive foreign bodies in adult ethiopian patients: a prospective study at tikur anbessa hospital, ethiopia.

Introduction. Foreign bodies (FBs) in the aerodigestive tract are important causes of morbidity and mortality and pose diagnostic and therapeutic challenges. The best method of removal of an esophageal and tracheobronchial FB is endoscopic guided extraction. Objective. To present our experience of the removal of aerodigestive FBs in adult Ethiopian patients using rigid endoscopes. Methods. A hospital-based prospective study, at Tikur Anbessa Referral and Teaching Hospital, from January 2011 to December 2012 (over two years). Results. A total of 32 patients (18 males and 14 females) with a mean age of 28.0 ± 12.74 years were treated for FB ingestion and aspiration at Tikur Anbessa Hospital. The FBs were impacted at the esophagus in 18 (56.2%) patients, at the pharynx in 7 (21.8%), and at the air way in 7 (21.8%) patients. Pieces of bones were the commonest objects found in the esophagus (17/18 of the cases) and the pharynx (4/7), while fractured tracheostomy tubes and needles were frequently seen in the air way (3/7 cases each). The foreign bodies were visible in plain radiographs of 26 (81.2%) patients. Successful extraction of FBs was achieved by using Mc gill forceps in 11 cases, rigid esophagoscopes in 9 patients, and bronchoscopes in 4 cases. Four cases required open surgery to remove the foreign bodies. Two complications (one pneumothorax and one esophageal perforation) occurred. All patients were discharged cured. Discussion and Recommendations. Aerodigestive FBs are not so rare in the hospital and timely diagnosis and removal of accidentally ingested and aspirated foreign body should be performed so as to avoid the potentially lethal complications associated. Rigid esophagoscopy requires general anesthesia and is associated with its own complications, but our experience and outcome of its use are encouraging.

Fractured tracheostomy tube obturator: A rare cause of respiratory distress in a tracheostomized patient

Fractured tracheostomy tube obturator: A rare cause of respiratory distress in a tracheostomized patient

Fractured tracheostomy tube as foreign body bronchus: Our experience with three cases

ObjectiveTracheostomy tubes are extensively used in paediatric age group for airway issues. Their fracture and lodgement into trachea is an acute emergency requiring urgent intervention. CasesWe report three such paediatric cases having tracheostomy tube fracture and aspiration into trachea with different presentations and treatment outcomes. ResultsOne patient was successfully managed with bronchoscopy and fractured tube removal. One patient succumbed to asphyxia before any intervention. The third patient was having supratubal tracheal stenosis making things more dangerous, but was managed successfully by tracheoscopy through tracheostomy opening with removal of fractured tube. ConclusionImmediate identification is the key to successful management of this rare but life threatening situation. In the presence of tracheal stenosis above the tracheostomy opening, situation becomes more dangerous with very limited options for management.

Fractured tracheostomy tube – A case report of a 3-year old Ghanaian child

Introduction: We report on a 3-year old Ghanaian child who had a fractured tracheostomy tube dislodged into the left main bronchus of the tracheobronchial tree. Case history: Child was involved in a rollover road traffic collision as an unrestrained passenger in a saloon car. Her injuries required mechanical ventilation and subsequently a tracheostomy. A week after the tracheostomy, a diagnosis of a fractured tracheostomy tube was made. Discussion: Fracture of a tracheostomy tube is a rare complication, which should be considered as part of the differential diagnosis in a ventilated patient with a tracheostomy. Wound exploration through the tracheal stoma is an alternative technique that can be adopted in a restricted resource setting. Introduction: Nous rapportons le cas d’une enfant ghanéenne de trois ans qui a un tube de trachéotomie fracturé déplacé dans la bronche principale gauche de l’arbre trachéo-bronchique. Etude de cas: L’enfant a été impliquée dans un accident de la route alors qu’elle était passagère sans ceinture dans une berline. Ses blessures ont nécessité une ventilation mécanique puis une trachéotomie. Une semaine après la trachéotomie, un diagnostic de tube de trachéotomie fracturé a été prononcé. Discussion: Une fracture du tube de trachéotomie est une complication rare, qui doit être considérée dans le cadre d’un diagnostic différentiel chez un patient ventilé avec une trachéotomie. Un examen de la blessure par le biais du stomate trachéal est une technique alternative pouvant être adoptée dans un contexte de ressources limitées.

Flexible Bronchoscopic Removal of a Fractured Metallic Tracheostomy Tube

Patients frequently require a tracheostomy for a variety of indications, but its prolonged use is associated with several complications, including fracture of the tube. Metallic tracheostomy tubes, which are often used in developing countries, are predisposed to such a complication essentially because of corrosion from prolonged used. We report 2 cases of a fractured tracheostomy tube inserted into the central airways, with different clinical presentations. Fractured pieces were successfully removed using a flexible bronchoscope under topical anesthesia.

Fractured metallic tracheostomy tube in a child: a case report and review of the literature

IntroductionTracheostomy is a common airway procedure for life support. The fracture of the tracheostomy tube is a rare complication. We report a case of a 14-year-old boy whose fractured stainless steel tracheostomy tube dislodged into the tracheobronchial tree. We include a literature review and proposed recommendations for tracheostomy care.Case presentationA 14-year-old Thai boy who had a stainless steel tracheostomy tube presented with a complaint of intermittent cough for 2 months. During tracheostomy tube cleaning, his parents found that the inner tube was missing. A chest X-ray revealed a metallic density foreign body in his right main bronchus. He underwent bronchoscopic removal of the inner tracheostomy tube and was discharged without further complications.ConclusionA fractured tracheostomy tube is a rare complication. Appropriate cleaning and scheduled replacement of the tracheostomy tube may prevent this complication.

Fractured Tracheostomy Tube Ingestion in a Pediatric Patient

Objective: To report a case of fractured tracheotomy tube ingestion in a pediatric patient, discussing the clinical presentation, complications and management of tracheobronchial tree versus upper digestive tract foreign bodies.
 
 Method: 
 Design: Case Report
 Setting: Tertiary Private Hospital 
 Subject: One
 
 Results: A 4-year-old male child with unusual hypersensitivity to routine tracheotomy suctioning was discovered to have a fractured tracheotomy tube. Emergency radiographs localized the cannula in the abdomen and bronchoscopy was deferred. The foreign body was eventually passed out after 4 days
 
 Conclusion: Due diligence in diagnostics prior to bronchoscopy led to the avoidance of an unnecessary and sometimes complicated procedure. In developing countries with poor access to health care, the importance of regular tracheotomy follow-ups and periodic replacement cannot be overemphasized. A search of the English literature using Pubmed and Ovid search engines with keywords tracheostomy, foreign bodies, and pediatrics confirms that this is the first reported accidental ingestion of a fractured tracheotomy tube in a pediatric patient
 
 Keywords: Tracheostomy, Complications, Foreign bodies, Pediatrics