[Indications for the correction of tracheal stenosis caused by prolonged artificial ventilation of polytraumatized persons (author's transl)].
Pronounced, short-length narrowing of the trachea combined with dyspnoea at rest is an absolute indication for partial resection. For stenoses of moderate degree the indications for surgical intervention are as yet not clearly defined. They depend not only on the clinical, roentgenological and tracheobronchoscopic findings, but also on the results of lung function tests. Changes in respiratory function become noticeable at reduction of under 30% of the tracheal diameter. Experiments with artificially induced stenosis have shown an exponential rise in flow resistance when the diameter of the trachea was narrowed to below 8 millimetre. observations made in patients have proved that the experimental results also apply clinically. The indications for surgery of a tracheal stenosis should be made dependent on the results of the determinations of flow resistance, whole body plethysmography and expiratory and inspiratory volume/1 sec. Flow resistance exceeding 5 cm H2O/1 sec, equivalent to narrowing to under 8 mm in diameter, is considered to be an indication for partial resection.
D006801:Humans; D010366:Peak Expiratory Flow Rate; D010993:Plethysmography, Whole Body; D012121:Respiration, Artificial / Q000009:adverse effects; D012129:Respiratory Function Tests; D014135:Tracheal Stenosis / Q000209:etiology / Q000601:surgery*
Indikation zur operativen Versorgung von Trachealstenosen nach Langzeitbeatmung Polytraumatisierter.