Kadasah Sultan K, Alshammari Abdulrazaq M, Alharbi Nader S, Alshehri Ibtihal S, Alasiri Raghad Y, Al Qahtani Abdulaziz, Al Shahrani Ali S
Department of Surgery, College of Medicine, University of Bisha, Aseer, Saudi Arabia.
Department of Otorhinolaryngology Head and Neck Surgery, King Salman Hospital, Riyadh, Saudi Arabia.
J Surg Case Rep. 2025 Apr 3;2025(4):rjaf194. doi: 10.1093/jscr/rjaf194. eCollection 2025 Apr.
Tracheostomy is a common surgery in children, usually required due to chronic respiratory insufficiency or neuromuscular illnesses. While tracheostomy considerably improves respiratory control, it also increases the risk of serious consequences such as tube dislodgement and blockage. This article describes a catastrophic event in which a dislodged tracheostomy tube (TT) occurred in a 10-year-old female patient with cerebral palsy who had been on ventilator support for 5 years. The dislodged tube slipped unnoticed into the right main bronchus, causing severe respiratory distress and sudden reduction in oxygen saturation. This life-threatening condition requires rapid diagnosis and surgical management. It also reviews the relevant literature to provide insights into best practices for managing similar cases, highlighting the importance of early identification and management of rare complications to prevent life-threatening outcomes. Key takeaways from this TT fracture case report highlight the importance of vigilance in long-term patient care. Early intervention is critical for patient safety, and healthcare providers should be aware of fracture risk in patients with prolonged TT use. Regular monitoring and maintenance are essential to prevent complications. This report emphasizes the need to investigate cleaning and sterilization methods to determine their impact on TT structural integrity.
气管切开术是儿童常见的手术,通常因慢性呼吸功能不全或神经肌肉疾病而需要进行。虽然气管切开术能显著改善呼吸控制,但也会增加诸如导管移位和堵塞等严重后果的风险。本文描述了一起灾难性事件,一名10岁患脑瘫的女性患者,已接受呼吸机支持5年,其气管切开导管发生移位。移位的导管不知不觉滑入右主支气管,导致严重的呼吸窘迫和氧饱和度突然下降。这种危及生命的情况需要快速诊断和手术处理。本文还回顾了相关文献,以深入了解处理类似病例的最佳做法,强调早期识别和处理罕见并发症以防止危及生命后果的重要性。这份气管切开导管断裂病例报告的关键要点突出了长期患者护理中保持警惕的重要性。早期干预对患者安全至关重要,医疗保健提供者应意识到长期使用气管切开导管的患者存在断裂风险。定期监测和维护对于预防并发症至关重要。本报告强调需要研究清洁和消毒方法,以确定它们对气管切开导管结构完整性的影响。