The use of expandable metal stents to facilitate extubation in patients with large airway obstruction.
OBJECTIVE
To determine the clinical utility of placing airway stents to facilitate weaning in ventilator-dependent patients with large airway obstruction.


METHODS
A chart review of mechanically ventilated patients who received expandable metal airway stents to attempt a facilitation of weaning.


RESULTS
Eight patients, 3 women and 5 men, ranging in age from 37 to 82 years, had respiratory failure associated with large airway obstruction and underwent flexible bronchofluoroscopic placement of 12 expandable metal stents (7 Wallstents [Schneider; Minneapolis, MN], 2 Palmaz [Johnson & Johnson; Warren, NJ], and 3 Ultraflex [Microinvasive; Natick, MA]). Six had respiratory failure that was secondary to malignant airway disease, and two had benign airway disease. Seven patients with tracheal or mainstem bronchial obstruction were weaned from the ventilator within 0 to 11 days of stent placement after having previously required mechanical ventilation from 2 to 52 days. There were no associated complications. Following prolonged attempts at weaning, one patient with lobar bronchus obstruction died after mechanical ventilation was withdrawn.


CONCLUSIONS
Expandable metal airway stents may be safely deployed in mechanically ventilated patients and can facilitate weaning from the mechanical ventilator. Mechanically ventilated patients with tracheal and mainstem bronchus obstruction are the best candidates for deployment of expandable airway stents to facilitate weaning.
Shaffer
J P
JP
The Ohio State University Medical Center, Division of Pulmonary and Critical Care Medicine, Columbus 43210, USA.
Allen
J N
JN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D015300:Ventilator Weaning