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Two Cases of Postintubation Tracheoesophageal Fistula in Patients with a History of Tracheostomy: Case Report
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Seung Chan Kim, Kyung Won Ha, Joon Ho Wang, Se Jin Kim, Won Hak Kim, So Hee Jeong, Woo Sung Lee, Sang Don Han, Gyu Rak Chon
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Korean J Crit Care Med. 2009;24(2):87-91.
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DOI: https://doi.org/10.4266/kjccm.2009.24.2.87
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 Abstract
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- Common causes of acquired tracheoesophageal (T-E) fistula are blunt trauma on the neck or chest, malignancy, long-term mechanical ventilation, and post-intubation injury. Most of the cases are fatal due to severe respiratory infection. We experienced two cases of post-intubation T-E fistula in patients with a history of tracheostomy that developed earlier than usual. One case was caused by excessive cuff pressure and the other by avulsion injury during endotracheal intubation. We can get instructions from these cases that how to prevent T-E fistula because it is hard to treat and causes severe outcomes.
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Citations
Citations to this article as recorded by  - Occurrence of Acquired Tracheoesophageal Fistula Due to Excess Endotracheal Tube Cuff Volumes - A Case Report -
Myeong Soo Kim, Eun Jeong Koh, Ha Young Choi
Korean Journal of Critical Care Medicine.2013; 28(2): 146. CrossRef - Acquired Tracheoesophageal Fistula through Esophageal Diverticulum in Patient Who Had a Prolonged Tracheostomy Tube - A Case Report -
Jae Hwan Jung, Ji Sung Kim, Yong Kyun Kim
Annals of Rehabilitation Medicine.2011; 35(3): 436. CrossRef
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Alteration of Lung Mechanics Depending on Expiratory Sensitivity (ESENS) during Pressure Support Ventilation
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Kwang Won Seo, Gyu Rak Chon, Jong Joon Ahn, Yangjin Jega, Sang Bum Hong, Chae Man Lim, Younsuck Koh
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Korean J Crit Care Med. 2006;21(1):8-16.
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Abstract
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- BACKGROUND
To evaluate effects of 5 expiratory sensitivity (ESENS) levels (5%; 15%; 25%; 35%; 45%) on lung mechanics and the effects depending on the two P(0.1) levels (<3 cm H2O; > or =3 cm H2O).
METHODS
Prospective, randomized, physiologic study for intubated adult patients during weaning from mechanical ventilation. Patients were randomly submitted to the 5 settings of ESENS in the Galileo ventilator (Galileo Gold, Hamilton Medical AG, Switzerland). Physiologic variables were continuously measured using a Bicore CP-100 pulmonary mechanics monitor (CP-100, Bicore, USA).
RESULTS
Thirteen patients, ten men and three women, with a mean age of 65.2+/-16.1 yr were studied. Tidal volume (V(T)) decreased significantly from ESENS 5% to 45%. With increasing levels of ESENS, respiratory rates (RR) steadily increased from ESENS 5% to 35% and 45%. Shallow breath index (F/V(T)) increased significantly from ESENS 5% to 45%.
Inspiratory time (T(I)) decreased gradually significantly from ESENS 5% to 45%. RR and F/V(T) increased from ESENS 5% to 15% and 45% and V(T) decreased gradually in patients with P(0.1)<3 cm H2O group, but not in patients with P(0.1)> or =3 cm H2O.
CONCLUSIONS
The proper adjustment of expiratory sensitivity (ESENS) levels improved patient-ventilator synchrony and decreased respiratory rates and shallow breath index, especially in P(0.1)<3 cm H2O during PSV in ventilator weaning patients. Lower ESENS level would be more appropriate in terms of lung mechanics in patients with less than 3 cm H2O of P(0.1).
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