Despite improvement of endotracheal tubes and tracheal intubation techniques, there are still major complications after intubation. Tracheal stenosis is the most serious complication in these patients. The incidence rate of post-intubation tracheal stenosis (PITS) is not the same in different countries. The high incidence might be estimated in countries, such as Iran, with high ICU bed occupancy and high population at risk. The patients with tracheal stenosis usually return to hospitals a couple of weeks after extubation for progressive dyspnea and stridor. Many of them are treated as asthma or respiratory infections. More unluckily, some of them also undergo tracheostomy before a correct diagnosis. The airway of patients should be temporarily kept open by repeated bronchoscopic dilation under general anesthesia, and airway resection and reconstruction would finally be required, if feasible. Therefore, tracheal stenosis can result in a significant physical, psychological, and economical surcharge to both the patients and the health system. Many of general physicians and even other unrelated specialties are not familiar with PITS and its life-threatening outcome or death.

Through the quantitative techniques (co-word and cluster analysis), our researchers reviewed and mapped,  the tracheal stenosis research fields published in Web of Science (WOS) and PubMed databases over the last 70 years. By these maps, we were able to show that prevention of post-intubation tracheal stenosis, educating the general physicians for referring the patients with exertional dyspnea following prolonged intubation to the related specialties, establishment of ICU follow-up clinics, comprehensive screening program and diminishing its risk factors have been studied less. Therefore, the researchers in Tracheal diseases Research Center designed a national longitudinal study to estimate the incidence rate of tracheal stenosis in Iran, which was remarkable, assessed its risk factors and designed a modern screening method for follow-up of ICU discharged patients. Now, the professionals are in the process of making a national guideline to prevent this underestimated complication of intensive care units as the best policy.

 


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