How to treat healthy breathing in critically ill patients

  Recently, a patient with severe tracheal stenosis was successfully operated and treated in our Thoracic and Cardiovascular Surgery Department, and the patient regained healthy breathing after the possible asphyxiation crisis was lifted at any time. Behind the scenes of this difficult patient’s recovery is a story of a multidisciplinary and multi-team relay of the First Affiliated Hospital, full of love!  The unfortunate old Liu was admitted to our hospital because of high-voltage electric shock injury, with deep burns, severe infection, respiratory failure and critical condition. After the joint treatment by the Department of Critical Care Medicine and the Department of Burns, the patient finally turned to safety and was transferred to the Department of Burns for further treatment. Under the careful care of the burn team led by Director Huilai and Director Li Jiyang, the burn wounds of Lao Liu gradually healed. Unexpectedly, more than eighty days after the burn injury, serious illness came again. After consultation with the Department of Thoracic and Cardiovascular Surgery and the Department of Ear, Nose and Throat, a detailed examination revealed that Lao Liu had suffered from tracheal stenosis, which was also a severe stenosis in the cricoid cartilage area. The cause of the disease was a nearly healed electrical burn on the left side of the neck. One of the characteristics of electric burns is that the deep damage often far exceeds the skin entrance, so some symptoms are difficult to determine early after the electric burns. The electrical burns on the skin of Liu’s neck were transmitted to the subacromial region, damaging the cricoid cartilage and causing severe respiratory distress due to secondary scar formation and progressive aggravation. Lao Liu was quickly transferred to the Department of Thoracic and Cardiovascular Surgery for further treatment. Prof. Shuanglin Zhang, vice president of operations, led the entire department in a comprehensive departmental discussion. The burn unit worked tirelessly and ran around every day to continue implementing wound dressing change treatment. Director Zhou Qing of the Radiology Department performed tracheal reconstruction using Gem CT, and Director Qin Wenjing of the Respiratory Department performed tracheoscopy to further confirm the characteristics of the lesion. The face of the tracheal stenosis was further clarified: the stenosis started to appear 25px below the voice box and was only 3mm×8mm at the most severe point, with the full stenotic segment above 25mm.  Tracheal stenosis is an obstruction of the airway causing shortness of breath and dyspnea, aggravated by physical activity and increased secretions in the airway, often with marked wheezing, and in severe cases death by acute asphyxia. Circumferential resection of the lesion with end-to-end anastomosis is the main treatment for tracheal stenosis, especially benign tracheal stenosis, which allows complete treatment of the lesion and minimizes the need for foreign objects such as stents. For tracheobronchial stenosis caused by malignant tumors, airway laser and airway stent placement can also be chosen, which can restore the ventilation function of the occluded or narrowed tracheobronchus in a very short period of time, improve the patient’s quality of life, prolong survival time, and gain valuable time for the treatment of the primary disease.  Fire and water have no mercy, and disease has no mercy! Under the careful treatment of several medical and nursing teams in the First Affiliated Hospital, love was passed among the angels. On New Year’s Eve, with the sound of firecrackers outside the window, the medical and nursing staff of the Department of Thoracic and Cardiovascular Surgery served Lao Liu with hot dumplings and sent him sincere wishes for the New Year!