Tracheal Stenosis After Prolonged Intubation Due to COVID-19

Abstract

Objectives: The authors aimed to evaluate the characteristics and management outcomes of patients who developed tracheal stenosis after invasive mechanical ventilation (IMV) due to COVID-19.

Design, setting, and participants: The data of 7 patients with tracheal stenosis and 201 patients without tracheal stenosis after IMV due to COVID-19 between March 2020 and October 2021 were retrospectively analyzed.

Interventions: Flexible bronchoscopy was performed for the diagnosis of tracheal stenosis and the evaluation of the treatment's effectiveness, and rigid bronchoscopy was applied for the dilatation of tracheal stenosis.

Measurements and main results: In the follow-up period, tracheal stenosis was observed in 7 of 208 patients (2 women, 5 men; 3.3%). The patients were divided into 2 groups as patients with tracheal stenosis (n = 7) and patients without tracheal stenosis (n = 201). There were no statistically significant differences between the 2 groups in terms of age, sex, body mass index, and comorbidities (p > 0.05). The mean duration of IMV of the patients with tracheal stenosis was longer than patients without tracheal stenosis (27.9 ± 13 v 11.2 ± 9 days, p < 0.0001, respectively). Three (43%) of the stenoses were web-like and 4 (57%) of them were complex-type stenosis. The mean length of the stenoses was 1.81 ± 0.82 cm. Three of the patients were treated successfully with bronchoscopic dilatation, and 4 of them were treated with tracheal resection.

Conclusions: Tracheal stenosis developed in 7 of 208 (3.3%) patients with COVID-19 who were treated with IMV. The most important characteristic of patients with tracheal stenosis was prolonged IMV support.

Keywords: COVID-19; bronchoscopic dilatation; invasive mechanical ventilation; tracheal resection; tracheal stenosis.