Application of tracheotomy combined with thyrocricocentesis and puncture of front tracheal wall in emergency treatment of laryngeal edema in burn patients

Objective To explore the effect of tracheotomy combined with thyrocricocentesis and puncture of front tracheal wall in emergency treatment of laryngeal edema in patients with burns. Methods From November 2000 to August 2018, 22 patients with severe burn or extremely severe burn combined with acute laryngeal edema were rescued in the author′s unit, including 18 males and 4 females, aged 17 to 68 years. All patients were complicated with mild inhalation injury or above and more than deep partial-thickness burn to head, face, and neck. From November 2000 to October 2012, simple emergency tracheotomy was performed for 12 cases. From May 2013 to August 2018, tracheotomy combined with thyrocricocentesis and puncture of front tracheal wall was performed for 10 cases. Rescue effect and complication of the two kinds of tracheotomy were recorded. Data were processed with Fisher′s exact probability test. Results Among the 12 patients treated with simple emergency tracheotomy, 5 cases survived and 7 cases died of suffocation during tracheotomy. Among the 10 patients treated with tracheotomy combined with thyrocricocentesis and puncture of front tracheal wall, 9 cases survived and 1 case died of cardiac arrest caused by arrhythmia. There was statistically significant difference in successful rescue effect between the two kinds of tracheotomy (

<0.05). Among the 14 patients who were successfully rescued, symptoms of insomnia and post-traumatic stress disorder occurred in 12 cases, which were relieved after symptomatic treatment for 14 to 45 d without permanent hypoxic brain damage. Conclusions In case of loss of the condition of preventive tracheotomy, first aid of acute laryngeal edema of burn patient is very difficult. Tracheotomy combined with thyrocricocentesis and puncture of front tracheal wall is simple and rapid with high successful rate and amelioration of hypoxia, which is an ideal plan for laryngeal edema.