Tracheomalacia in the critical care unit. Report of 2 cases.

Abstract

Introduction: Tracheomalacia in critical care is a rare entity in the adult population, so we present two relevant clinical cases, where a striking deformity of the trachea was evident. In the first case, concomitantly with other diseases such as thyroid pathologies (goiter) and in the second case as a result of severe burns, product of the explosion of a gas canister for domestic use. Objective: to describe two clinical cases of patients with tracheomalacia in critical care unit and to recognize the main diagnostic and therapeutic methods. Materials and methods: a retrospective descriptive study was performed, presentation of 2 clinical cases, with a diagnosis of tracheomalacia in the critical care unit; institutional informed consent was requested for review of clinical histories of the patients studied and publication of the respective images. Discussion: The main signs and symptoms in both clinical cases were dyspnea, hypoxemia and failure of extubation. In the first clinical case, the diagnosis of tracheomalacia, was found during surgery for exeresis of thyroid tumor, in the second case the diagnosis was made by fibrobronchoscopy and anatomical loss was observed in the normal way, cylindrical of the trachea. With regard to treatment, it should be emphasized that tracheal surgery and the development of endoluminal tracheal prostheses currently represent a great therapeutic alternative. Conclusions: tracheomalacia can cause serious changes in oxygenation so it is important to recognize, diagnose and treat this pathology in a timely manner, as it represents a high comorbidity in the critical patient, which increases the need for reintubation and increases failure in disconnecting mechanical ventilation.