Little Benjamin W, Fowler William M, Gibson Steve, Popa Christian, Hodgson John A
Department of Anesthesia, Walter Reed NMMC, Bethesda, MD 20889, USA.
Mil Med. 2023 Jul 22;188(7-8). doi: 10.1093/milmed/usac017. Epub 2022 Mar 12.
We present the case of a tracheal injury that occurred during a Maze procedure performed via sternotomy that was not initially detected by ventilator air leak, but rather by the visual presence of gas bubbles escaping the trachea during chest irrigation. Careful investigation and machine check did reveal a subsequent air leak that would have otherwise been overlooked. Furthermore, the use of intraoperative bronchoscopy was essential in guiding and confirming surgical repair. This case underscores the need for ongoing vigilance and suggests the utility of chest irrigation with Valsalva maneuvers after procedures performed in the vicinity of the trachea to exclude injury.
我们报告一例在通过胸骨切开术进行迷宫手术过程中发生的气管损伤病例。该损伤最初未通过呼吸机漏气检测到，而是在胸部冲洗时通过气管逸出气泡的视觉表现发现的。仔细检查和机器检测确实发现了随后的漏气，否则这一情况可能会被忽视。此外，术中支气管镜检查对于指导和确认手术修复至关重要。该病例强调了持续保持警惕的必要性，并提示在气管附近进行手术后通过瓦尔萨尔瓦动作进行胸部冲洗以排除损伤的实用性。
