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| Analysis of risk factors for asphyxia caused by sputum retention after tracheal stent implantation |
| SHI Xiao-bao1, ZHAO Gang2, FEI Cheng2, SUN Ling-ling1 |
1.Department of Radiology, The Fourth Hospital of China Medical University, Shenyang 110032, China;
2.Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004, China |
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Abstract Objective: To investigate the risk factors of asphyxia caused by sputum retention and to analyze the correlation between the risk factors and the occurrence of asphyxia after stent implantation. Methods: A total of 110 patients with central airway obstruction or tracheal fistula who were encountered in author’s hospital during the period from Jan. 2011 to Jan. 2016 were enrolled in this study. Tracheal stent placement was performed in all patients. After the treatment, the patients were divided into two groups based on the occurrence of asphyxia caused by sputum retention. According to literatures, we choose risk factors such as gender, etiology, types of stents, infection and the history of radiotherapy. The data were compared between the two groups through the univariate factor and multivariate factor analysis to evaluate their correlations. Results: 18 cases(16.4%) showed sputum retention with asphyxia and died as a result of respiratory and circulatory failure. In all patients with asphyxia, univariate analysis suggests that stent type, pleural effusion, anemia and respiratory failure were the risk factors leading to asphyxia. Age, etiology, and the history of radiotherapy were not significantly different. Multivariate analysis showed that preoperative type Ⅱ respiratory failure was significantly related to the occurrence of postoperative asphyxia. Conclusion: The presence of preoperative type Ⅱ respiratory failure is a significant risk factor associated with asphyxia caused by sputum retention after tracheal stent implantation.
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Received: 03 August 2017
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[1]Bond CJ. Note on the treatment of tracheal stenosis by a new T shaped tracheotomy tube[J]. Lancet, 1891, 1: 539.
[2]Chin CS, Litle V, Yun J, et al. Airway stents[J]. Ann Thorac Surg, 2008, 85(2): S792-796.
[3]Maeda K, Ono S, Tazuke Y, et al. Long-term outcomes of congenital tracheal stenosis treated by metallic airway stenting[J]. J Pediatr Surg, 2013, 48(2): 293-296.
[4]Murray, Nade. Texbook of Respiratorg Medicine[M]. Pliadelph in Sauunders, 1994: 511-512.
[5]Cosano PA, Munoz CL, Cosano P, et al. Endoscopic treatment of central airway stenosis: five years’ experience[J]. Arch Bronconeumol, 2005, 41(6): 322-327.
[6]Lemalre A, Burfelnd WR, Toloza E, et al. Outcomes of tracheobronchial stents in patients with malignant airway disease[J]. Ann Thorac Surg, 2005, 80(2): 434-437.
[7]Asopa S, Moorjani N, Saad RA, et al. Rare and fatal complication of Gianturco tracheobronchial stent[J]. Ann Thorac Surg, 2007, 84(5): 1758-1760.
[8]Ernst A, Feller-Kopman D, Becker HD, et al. Central airway obstruction[J]. Am J Respir Crit Care Med, 2004, 169(12): 1278-1297.
[9]Breitenbucher A, Chhajed PN, Brutsche MH, et al. Long-term follow-up and survival after Ultraflex stent insertion in the management of complex malignant airway stenoses[J]. Respiration, 2008, 75(4): 443-449.
[10]Grosu HB, Eapen GA, Morice RC, et al. Stents are associated with increased risk of respiratory infections in patients undergoing airway interventions for malignant airways disease[J]. Chest, 2013, 144(2): 441-449.
[11]Madan K, Dhooria S, Sehgal IS, et al. A Multicenter Experience With the Placement of Self-Expanding Metallic Tracheobronchial Y Stents[J]. Bronchol Intervent Pulmonol, 2016, 23(1): 29-38.
[12]Porcel JM, Light RW. Pleural effusions[J]. Dis Mon, 2013, 59(2): 29-57. |
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2018, Vol. 29 
