Tracheal stenosis following intubation due to cardiogenic shock – a particular challenge?

Introduction: We hypothesise that management of tracheal stenosis (TS) following intubation due to cardiogenic shock is particularly difficult. Methods: Retrospective study of patients with TS and history of intubation submitted to bronchoscopic procedures in a Bronchoscopy Unit, from 2014 to 2018. Patients were divided in 2 groups: I – intubation due to cardiogenic shock; II – intubation due to other causes. Clinical data was reviewed. Results: From a total of 55 patients with benign TS, 48 (87.3%) had history of intubation. Three were excluded due to missing cause of intubation. Out of 45 included patients (27 men, median age 58 years, 18 with smoking history), 13 (28.9%) matched group I and 32 (71.1%) group II. Patients’ characteristics and procedures are shown in Table 1. Group I was submitted to significantly more rigid bronchoscopies (6 vs 2, p 0.031) and mechanical dilations (5 vs 2, p 0.031) compared to group II. Discussion: Almost 30% of patients with TS were intubated due to cardiogenic shock. These patients required a higher number of endoscopic procedures, reflecting a more complex management. It would be important to identify risk factors and implement preventive strategies of tracheal injury in these at risk patients. Data: median (IQR), no. of patients (%) or no. of procedures