. 2021; 19(1): 50-53 | |||
Postoperative Respiratory Distress due to Laryngeal Granuloma and Subglottic Stenosis in a Patient Undergoing Open Heart SurgeryÇağla Yazar, Manat Aitakhanova, Aykan Gülleroğlu, aynur camkiran firat, Pinar ZeynelogluBaşkent University The Faculty Of Medicine Department Of AnesthesiologyThe cause of impairment in respiratory functions after open heart surgery is multifactorial.Case: A 67-year-old female patient was admitted to the intensive care unit (ICU) as intubated after mitral valve replacement and tricuspid annuloplasty. She was extubated on the first postoperative day. On the postoperative 5th day, the patient was re-admitted to the ICU due to respiratory distress and tachypnea. Noninvasive mechanical ventilation (NIMV) support and dobutamine 5mcg/kg/min were started. Tazocin 3x4.5 grams started with prediagnosis of septic shock. The patient was intubated on the 6th postoperative day because of the increase in respiratory distress. She was extubated on the postoperative 7th day, and NIMV was started. On the 8th postoperative day, she was consulted to the ENT department because of sore throat. Widespread mucosal aphthous lesions were observed in the uvula, soft and hard palate, mandible inner mucosa and alveolar process. When Galactomannan was positive in bronchoalveolar lavage, fluconozole treatment was started. The patient was discharged on the postoperative 15th day. On the same night, she was admitted to the ICU again due to sudden respiratory distress and NIMV support was started, but the patient whose respiratory distress increased and was unconscious was intubated. The next day, direct laryngoscopy was performed by the ENT department under operating room conditions, and a 3x4 cm polypoid lesion was removed from the vocal cord level. However, after 2 days, the patient was re-examined by direct laryngoscopy, necrotic crusts were removed under the cricoid cartilage posteriorly in the subglottic region, the patient recovered from postoperative respiratory distress, was extubated on the 18th postoperative day and his support with NIMV continued. The patient was discharged on the 33rd postoperative day.Conclusion: Laryngeal granuloma and subglottic strictures should be kept in mind in patients with postoperative respiratory distress, no matter how short the intubation period is. Keywords: Subglottic Strictures, Laryngeal Granuloma, mitral valve replacement and tricuspid annuloplastyAçık Kalp Cerrahisi Uygulanan Hastada Laringeal Granüloma ve Subglottik Darlığa Bağlı Postoperatif Solunum SıkıntısıÇağla Yazar, Manat Aitakhanova, Aykan Gülleroğlu, aynur camkiran firat, Pinar ZeynelogluBaşkent Üniversitesi Tıp Fakültesi Anesteziyoloji Anabilim DalıAçık kalp cerrahisi sonrasında solunum fonksiyonlarında bozulmanın nedeni multifaktöriyeldir. Çağla Yazar, Manat Aitakhanova, Aykan Gülleroğlu, aynur camkiran firat, Pinar Zeyneloglu. Postoperative Respiratory Distress due to Laryngeal Granuloma and Subglottic Stenosis in a Patient Undergoing Open Heart Surgery. . 2021; 19(1): 50-53 Corresponding Author: Çağla Yazar, Türkiye |
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