Ho Chi Minh CityA 62-year-old female patient had to wear a tracheostomy tube in her neck, unable to talk or breathe through her nose for 7 months after contracting Covid because of the narrow scarred airway.
She was admitted to a field hospital in a state of respiratory failure, coma, requiring intubation and prolonged mechanical ventilation in November 2021. After that, the patient gradually recovered, was tracheostomy and weaned from the ventilator.
However, after discharge from the hospital, the patient still had to wear a tracheostomy tube in the neck because of repeated failed attempts to withdraw. In 7 months, she could not speak, and wearing a canule also stimulated more mucus in the patient’s lungs. Family members must use a machine to aspirate fluid in the breathing tube. In addition, she has a background of diabetes, and her age increases the risk of making it harder for the wound to heal.
At Nguyen Tri Phuong Hospital, doctors surgically removed the canule, cut the narrow scar, connected the trachea, helping to open the airway again. After surgery to remove the canule, she can breathe through her nose, talk, communicate, the wound heals well.
“The patient really returned to a normal life,” said Doctor Ngo The Hai, deputy head of the Department of Otolaryngology, May 16.
Dr Lam Huyen Tran, Head of the Department of Otolaryngology, Nguyen Tri Phuong Hospital, said that this is a case of tracheal stenosis after long-term intubation. Severe narrowing scarring completely blocks the lumen of the trachea for a length of 5-6 cm, like a cork blocking the airway. Patients who cannot breathe must depend on a tracheostomy canule. In this case, if the canule is not surgically removed, the patient may have to wear the canule for the rest of his life.
Depending on the canule often makes the patient face many disadvantages, such as limitations in the process of communication, not being able to speak. Patients easily cough up sputum, mucus in the lungs splashes out, easy to infect, affect others, inconvenient in care and communication as well as in daily activities.
In particular, when breathing through the nose, thanks to the nasal hair system, the upper respiratory tract mucosa filters air, warms, humidifies and cleans bacteria and pathogens. When tracheostomy and canule are placed, the role of the nose and upper airway is limited, air goes directly through the tracheostomy, into the lungs. Patients are susceptible to pneumonia, said Dr. Tran.
Doctors recommend that patients who have to have a tracheostomy tube placed after discharge from the hospital should not skip the follow-up period. Because at this time, the doctor will appoint an endoscopy, CT scan, assessment of the injury to consider the possibility of withdrawing the canule, helping the patient recover soon and breathe normally.
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