Evidence map›Paper›PMID 31656172›Full record

ArticleBMC anesthesiology2019

Thoracotomy for emergency repair of iatrogenic tracheal rupture: single center analysis of perioperative management and outcomes.

Manuel F Struck, Gunther Hempel, Uta C Pietsch, Johannes Broschewitz, Uwe Eichfeld, Robert Werdehausen, Sebastian Krämer

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC anesthesiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.3field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 10 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Manuel F StruckDepartment of Anesthesiology and Intensive Care Medicine, University Hospital Leipzig, Liebigstr.20, 04103, Leipzig, Germany. manuelstruck@web.de.ORCID 0000-0002-0070-3406
Gunther HempelDepartment of Anesthesiology and Intensive Care Medicine, University Hospital Leipzig, Liebigstr.20, 04103, Leipzig, Germany.
Uta C PietschDepartment of Anesthesiology and Intensive Care Medicine, University Hospital Leipzig, Liebigstr.20, 04103, Leipzig, Germany.
Johannes BroschewitzDepartment of Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital Leipzig, Liebigstr. 20, 04103, Leipzig, Germany.
Uwe EichfeldDepartment of Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital Leipzig, Liebigstr. 20, 04103, Leipzig, Germany.
Robert WerdehausenDepartment of Anesthesiology and Intensive Care Medicine, University Hospital Leipzig, Liebigstr.20, 04103, Leipzig, Germany.
Sebastian KrämerDepartment of Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital Leipzig, Liebigstr. 20, 04103, Leipzig, Germany.
University Hospital Leipzig · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIatrogenic tracheal ruptures are rare but life-threatening airway complications that often require surgical repair. Data on perioperative vital functions and anesthetic regimes are scarce. The goal of this study was to explore comorbidity, perioperative management, complications and outcomes of patients undergoing thoracotomy for surgical repair.

methodsWe retrospectively evaluated adult patients who required right thoracotomy for emergency surgical repair of iatrogenic posterior tracheal ruptures and were admitted to a university hospital over a 15-year period (2004-2018). The analyses included demographic, diagnostic, management and outcome data on preinjury morbidity and perioperative complications.

resultsThirty-five patients who met the inclusion criteria were analyzed. All but two patients (96%) presented with critical underlying diseases and/or emergency tracheal intubations. The median time (interquartile range) from diagnosis to surgery was 0.3 (0.2-1.0) days. The durations of anesthesia, surgery and one-lung ventilation (OLV) were 172 (128-261) min, 100 (68-162) min, and 52 (40-99) min, respectively. The primary airway management approach to OLV was successful in only 12 patients (34%). Major complications during surgery were observed in 10 patients (29%). Four patients (11%) required cardiopulmonary resuscitation, one of whom received extracorporeal membrane oxygenation, and another one of these patients died during surgery. Major complications were associated with significantly higher all-cause 30-day mortality (p = 0.002) and adjusted mortality (p = 0.001) compared to patients with minor or no complications.

conclusionsSurgical repair of iatrogenic tracheal ruptures requires advanced perioperative care in a specialized center due to high morbidity and potential complications. Airway management should include early anticipation of alternative OLV approaches to provide acceptable conditions for surgery.

Indexed as

AdultAgedAged, 80 and overAirway ManagementCardiopulmonary ResuscitationEmergenciesExtracorporeal Membrane OxygenationFemaleHumansIatrogenic DiseaseIntubation, IntratrachealMaleMiddle AgedOne-Lung VentilationPerioperative CareRetrospective StudiesAirway managementAnesthesiaComplicationIatrogenic tracheal ruptureOne-lung ventilationPerioperative managementSurgical repairThoracotomy

Identifiers

PMID31656172
PMCPMC6816164
OpenAlexW2982253607

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.