Traumatic bronchial injury management

Airway injuries or tracheobronchial injuries are defined as the injury to the larynx, trachea, carina, and main bronchi, and the bifurcation to lobar or secondary bronchi. These can be grossly divided into upper and lower airways. Trauma, both the penetrating variety as well as blunt forces, leads to disruption of these structures leading onto potentially fatal injuries.

Tracheobronchial injuries need a high degree of suspicion for early diagnosis. Prompt resuscitation and early intubation with ICD insertion are a life-saving measure. Where required, early exploration and primary anastomosis with early weaning off ventilatory support offers the best chance of recovery, and where necessary a decision to pursue conservative management is also essential.