Beschreibung:
<jats:title>Abstract</jats:title><jats:sec><jats:title>Objectives</jats:title><jats:p>Prolonged intubation is a known risk factor of LTS. LTS related to COVID‐19 may result in a different phenotype: pronation affects the location of stenosis and COVID‐19 pneumonia can decline lung mechanics. Therefore, airway management in these patients may carry unique challenges for both anesthesiologists and surgeons.</jats:p><jats:p>This prospective observational feasibility trial aims to evaluate the use of a novel thin, cuffed, endotracheal tube (Tritube) in combination with flow‐controlled ventilation (FCV) in the management of patients with COVID‐19‐related LTS undergoing laryngeal surgery.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>20 patients suffering from COVID‐19‐related LTS, as diagnosed by CT, requiring endolaryngeal surgery, with or without CO<jats:sub>2</jats:sub> laser, were included. Ultrathin endotracheal tube Tritube, together with FCV was used for airway management and ventilation. Feasibility, ventilation efficiency, and surgical exposure were evaluated.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Median duration of mechanical ventilation during their ICU stay was 17 days, (range, 7–27), and all patients had been pronated. In 18/20 patients, endoscopic diagnosis confirmed the initial CT diagnosis: posterior subglottic stenosis. Surgeons’ satisfaction on the view was rated 9 out of 10 (range 7–10), where 0 was the worst view and 10 was the best view. Hemodynamic and respiratory variables were within the normal clinical range during the surgical procedure. One patient that had a SpO2 of 90% before induction of anesthesia, a temporal drop to 89%, caused meeting the predefined requirement of “respiratory complication.”</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>This study demonstrates the feasibility of using Tritube with FCV in patients with relatively unusual subglottic posterior location tracheal stenosis, undergoing laryngotracheal surgery. Tritube provides a good surgical field and FCV provides highly adequate ventilation especially in patients with compromised lung mechanics.</jats:p></jats:sec><jats:sec><jats:title>Level of Evidence</jats:title><jats:p>IV, non‐comparitive prospective clinical trial with 20 patients.</jats:p></jats:sec>