[Massive hemorrhage induced by tracheo-innominate artery fistula in two infants].
Two cases of massive hemorrhagic shock induced by tracheo-innominate artery fistula are reported. The first case is a 4 year-old girl with encephalitis under prolonged mechanical ventilation. The second case is a 6 year-old tracheostomized girl with mental and motor retardation of congenital origin who has been taken care of at her home. This catastrophic complication is usually caused by long term placement of tracheostomy tube with the cuff inflated especially in malnourished pediatric patients. The cuff pressure is apt to be concentrated on one side of the tracheal wall especially in mechanically ventilated immobilized patients. Although this complication is rare because cuffed tube is currently avoided in pediatric patient, sophisticated care should be taken in managing tracheostomized patients.
Matsumoto
M
M
Department of Anesthesia and Intensive Care, Hiroshima City Hospital.
Kawakami
Y
Y
Naitoh
H
H
Higashi
T
T
Kohno
K
K
Uchida
H
H
Kurasako
T
T
Takatori
M
M
Tada
K
K
D016122:Brachiocephalic Trunk; D002648:Child; D002675:Child, Preschool; D005260:Female; D005402:Fistula / Q000150:complications*; D006801:Humans; D012771:Shock, Hemorrhagic / Q000209:etiology*; D014132:Trachea; D014139:Tracheostomy / Q000009:adverse effects*