https://doi.org/10.4081/monaldi.2021.1894
Large airway complications in COVID-19 pneumonia
Submitted: April 22, 2021
Accepted: July 13, 2021
Published: July 22, 2021
Accepted: July 13, 2021
Abstract Views: 2756
PDF: 653
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
COVID-19 pneumonia can cause respiratory failure which requires specialist management. However the inflammatory nature of the condition and the interventions necessary to manage these patients such as endotracheal intubation and tracheostomy can lead to large airway pathology which may go unrecognised. We describe five of the 44 (11%) consecutive patients referred to our specialist ARDS team between April and June 2020 with confirmed COVID-19 pneumonia who developed diverse large airway pathology which comprised of: supraglottic oedema, tracheal tear, tracheal granulation tissue formation, bronchomalacia, and tracheal diverticulum. Large airway pathology may be underappreciated in severely ill patients with COVID-19 pneumonia and should be considered in patients with unexplained air leak, prolonged need for mechanical ventilatory support, and repeated failed extubation or decannulation. If suspected, such patients should be managed by a team with expertise in large airway intervention and early specialist advice should be sought.
Wiersinga W, Rhodes A, Cheng AC et al. Pathophysiology, transmission, diagnosis, and treatment of Coronarvirus Disease 2019 (COVID 19). A Review. JAMA 2020;324:8.
DOI: https://doi.org/10.1001/jama.2020.12839
Anwar A, Ramos-Bascon N, Crerar-Gilbert A, et al. A specialised cardiorespiratory team approach in the intensive care management of COVID-19 patients: benefit on mortality, diagnosis and management. Clin Med (Lond) 2021;21:101-6.
DOI: https://doi.org/10.7861/clinmed.2020-0788
Brodsky MB, Levy MJ, Jedlanek E, et al. Laryngeal injury and upper airway symptoms after oral endotracheal intubation with mechanical ventilation during critical care: A systematic review. Crit Care Med 2018;46:2010-7.
DOI: https://doi.org/10.1097/CCM.0000000000003368
Chao TN, Harbison SP, Braslow BM, et al. Outcomes after tracheostomy in COVID-19 patients. Ann Surg 2020;272:e181-6.
DOI: https://doi.org/10.1097/SLA.0000000000004166
Oliver CM, Campbell M, Dulan O. Appearance and management of COVID-19 laryngo-tracheitis: two case reports. F1000Res 2020;9:310.
DOI: https://doi.org/10.12688/f1000research.23204.2
Minambres E, Buron J, Ballesteros MA. Tracheal rupture after endotracheal intubation: a literature systematic review. Eur J Cardiothorac Surg 2009;35;1056-62.
DOI: https://doi.org/10.1016/j.ejcts.2009.01.053
Wali A, Rizzo V, Bille A. Pneumomediastinum following intubation in COVID-19 patients: a case series. Anaesthesia 2020;75:1076-81.
DOI: https://doi.org/10.1111/anae.15113
Mangel T, Madden BP. Acute tracheal tear – A potential cause of spontaneous pneumomediastinum in patients with COVID-19. Monaldi Arch Chest Dis 2021;91:1852.
DOI: https://doi.org/10.4081/monaldi.2021.1852
Madden BP, Datta S, McAnulty GR. Tracheal granulation tissue after percutaneous tracheostomy treated with Nd:Yag laser: three cases. J Laryngol Otol 2001;115:743-4.
DOI: https://doi.org/10.1258/0022215011908810
Touman A, Stratakos G. Long-term complications of tracheal intubation. In: R. Hakan Erbay, editor. Tracheal Intubation. IntechOpen; 2018.
DOI: https://doi.org/10.5772/intechopen.74160
Bacon J, Patterson C, Madden BP. Indications and interventional options for non-resectable tracheal stenosis. J Thorac Dis 2014;6:258-70. March 2014.
RECOVERY Collaborative Group, Horby P, Lim WS, et al. Dexamethasone in hospitalized patients with Covid-19. N Engl J Med 2021;384:693-704.
DOI: https://doi.org/10.1056/NEJMoa2021436
Marty-Ane CH, Picard E, Jonquet O, Mary H. Membraneous tracheal rupture after endotracheal intubation. Ann Thorac Surg 1995;60:1367-71.
DOI: https://doi.org/10.1016/0003-4975(95)00643-Y
Ozcan A, Balci C, Aksoy S. Upper airway injury caused by gum elastic bougie. Int J Case Rep Images 2017;8:439-43.
DOI: https://doi.org/10.5348/ijcri-201763-CR-10802
Arndt G, Cambray A, Tomasson J. Intubation bougie dissection of tracheal mucosa and intratracheal airway obstruction. Anesth Analg 2008;107:603-4.
DOI: https://doi.org/10.1213/ane.0b013e318176fe36
Supporting Agencies
NoneHow to Cite
May, James, Nordita Ramos-Bascon, Natalie Barnes, and Brendan Madden. 2021. “Large Airway Complications in COVID-19 Pneumonia ”. Monaldi Archives for Chest Disease 92 (1). https://doi.org/10.4081/monaldi.2021.1894.
Copyright (c) 2021 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Similar Articles
- Sotirios D. Moraitis, Apostolos C. Agrafiotis, Amalia Kapranou, Marina Constantinou, Konstantinos Kanakakis, Panagiotis Hountis, Occurrence of thymic pathology in two families. Is familial screening justified? , Monaldi Archives for Chest Disease: Vol. 88 No. 3 (2018)
- Neeta Singla, Amitesh Gupta, U.K. Khalid, Ravindra Kumar Dewan, Rupak Singla, Clinical profile, risk factors, disease severity, and outcome for COVID-19 disease in patients with tuberculosis on treatment under the National Tuberculosis Elimination Program: a cohort of 1400 patients , Monaldi Archives for Chest Disease: Early Access
- Sotirios D. Moraitis, Apostolos C. Agrafiotis, Dimitrios Pappas, Chrysovalantis Pothitakis, Maria Stergianni, Ioannis Koukis, Thymic pathology and cardiac myxomas: Coincidence or a closer relationship? , Monaldi Archives for Chest Disease: Vol. 88 No. 1 (2018)
- A. Chroneou, N. Zias, A.V. Gonzalez, J.F. Beamis Jr, Tracheobronchopathia Osteochondroplastica. An underrecognized entity? , Monaldi Archives for Chest Disease: Vol. 69 No. 2 (2008): Pulmonary series
- Cuneyt Tetikkurt, Nail Yılmaz, Seza Tetikkurt, Şule Gundogdu, Rian Disci, The value of exfoliative cell cytology in the diagnosis of exudative pleural effusions , Monaldi Archives for Chest Disease: Vol. 88 No. 3 (2018)
- Eirini-Chrisovalanto Bota, Dimitra Koumoundourou, Panagiota Ravazoula, Vasiliki Zolota, Charalambia Psachoulia, Maria Kardari, Theodoros Karampitsakos, Argyrios Tzouvelekis, Vasiliki Tzelepi, Fotios Sampsonas, A comprehensive analysis of GATA3 expression in carcinomas of various origins with emphasis on lung carcinomas , Monaldi Archives for Chest Disease: Vol. 94 No. 2 (2024)
- Sh. Karimi, F. Mohammadi, S. Pejhan, M. Bakhshayeshkaram, P. Akhavan-Azari, M. Bahadori, Hemomediastinum and bilateral hemothorax with extensive angiomatosis of anterior mediastinum , Monaldi Archives for Chest Disease: Vol. 65 No. 3 (2006): Pulmonary series
- Shekhar Kunal, Sudhir Jain, Ashok Shah, Middle lobe syndrome: An exceptional presentation of concomitant lepidic adenocarcinoma and bronchial anthracofibrosis , Monaldi Archives for Chest Disease: Vol. 87 No. 3 (2017)
- Davide Zampieri, Alessandro Pangoni, Giuseppe Marulli, Federico Rea, Acquired tracheoesophageal fistula repair, due to prolonged mechanical ventilation, in patient with double incomplete aortic arch , Monaldi Archives for Chest Disease: Vol. 88 No. 3 (2018)
- Janet Fallon, Martin Plummeridge, Richard Daly, Andrew Medford, Linear probe 19-gauge endobronchial ultrasound diagnosis of a benign chondroid hamartoma , Monaldi Archives for Chest Disease: Vol. 88 No. 1 (2018)
You may also start an advanced similarity search for this article.
