Abstract
A 67-year-old woman was admitted with cardiopulmonary arrest to our hospital's emergency and critical care medical center. The patient's heartbeat was restarted with cardiopulmonary resuscitation. Reintubation with an endotracheal tube was performed, but it was difficult to insert it more than 18 cm because of the circumferential hypertrophy of the tracheal wall demonstrated by computed tomography. We later obtained clinical records showing that she had been extubated about 4 weeks previously after artificial ventilation with intubation for the treatment of acute pneumonia for 13 days in another hospital. Although the patient was slightly hoarse after extubation, stridor was not heard. She had been diagnosed as having sleep apnea syndrome 2 weeks after extubation. Although dyspnea at rest appeared approximately 3 weeks after extubation, she was diagnosed as having asthma. She subsequently exhibited stridor, paradoxical respiration, and chest-wall retraction prior to cardiopulmonary arrest. Histological findings revealed that the hypertrophy of the tracheal wall was due to granulation tissue proliferation. These results indicate that it is necessary to take postintubation tracheal stenosis into consideration with early confirmation of the intubation record in the clinical process.
