КЛИНИЧЕСКИЙ СЛУЧАЙ БЫСТРОГО ВОССТАНОВЛЕНИЯ ПРОХОДИМОСТИ ДЫХАТЕЛЬНЫХ ПУТЕЙ С ДАЛЬНЕЙШЕЙ ИСКУССТВЕННОЙ ВЕНТИЛЯЦИЕЙ ПУТЕМ ИСПОЛЬЗОВАНИЯ ЧРЕСКОЖНОЙ ТРАХЕОСТОМИИ ПО МЕТОДИКЕ GRIGGS ПРИ СОЧЕТАННОЙ ТРАВМЕ ШЕИ И ГРУДНОЙ КЛЕТКИ

Abstract

Tracheotomy is one of the oldest surgical procedures, described as early as in Egyptian tablets in 3600 BC. The first report of opening the «arteria aspera» for suffocation was made by the Roman physician Asclepiades of Bithynia in 124 BC. With the advancement of medicine and the level of resuscitation care using intubation and mechanical ventilation (MV), the indications have changed, and the technique of tracheotomy has also been refined. Currently, several methods of tracheostomy placement are distinguished:
1.    Classic, or open («tracheostomy», from the Greek τραχειο – windpipe and στομα – mouth, opening; «tracheotomy», from the Greek τραχειο – windpipe and τομάια – incision, cutting) – opening the tracheal lumen, inserting a cannula into its lumen, and forming a non-permanent tracheostoma.
2.    Dilational – placement of a tracheostomy cannula into a channel formed through a series of sequential percutaneous dilations of the neck tissues using special bougies (P. Ciaglia) with subsequent transverse stretching of the tracheal annular ligaments using a modified Howard-Kelly clamp (W. Griggs) at the final stages to reduce the risk of fracture and depression of its semirings by the bougies. Furthermore, the retrograde translaryngeal tracheotomy by A. Fantoni and the percutaneous balloon dilatational tracheotomy by M.A. Zgoda are known. It should be noted that percutaneous tracheostomy (PT) is more commonly used to secure the airway in intensive care unit patients, while the feasibility of performing this technique in emergency situations remains a subject of debate.