Complicações das vias aéreas relacionadas à intubação endotraqueal

Martins, Regina Helena Garcia; Dias, Norimar Hernandes; Bráz, José Reinaldo Cerqueira; Castilho, Emanuel C.

doi:10.1590/s0034-72992004000500015

Cited by 22 publications

(36 citation statements)

References 28 publications

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“…4,5 The common pathophysiological condition in these lesions is ischemia of the mucosa, especially due to wider diameter endotracheal tubes and high cuff pressures. Along these lines, Nordin13 undertook an interesting experimental study of intubated rats in which he varied the balloon pressure from 20 to 100 mmHg, finding that lesions were directly related with increased pressure in the balloon, particularly when above the capillary perfusion pressure (25 mmHg).…”

Section: Discussionmentioning

confidence: 99%

Aspectos clínicos, histológicos e de microscopia eletrônica dos granulomas de intubação das pregas vocais

Martins¹,

Dias²,

Santos³

et al. 2009

Rev. Bras. Otorrinolaringol.

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Granul omas are bilateral and pediculated lesions of the vocal apophysis. Etiologies: intubation, reflux, trauma, vocal abuse, idiopathic origin. Aim: To analyze the clinical and morphological aspects of post intubation granulomas. Methods: retrospective study of patients submitted to microsurgery for post intubation laryngeal granulomas seen at our Medical School starting in 2002. We analyzed: age, gender, indication and time of intubation, symptoms, videolaryngoscopic diagnosis and biopsy findings. Light microscopy was performed on all specimens, and electron microscopy on three of them. Results: ten patients (7 females and 3 males), between the ages of 2 and 72 years, intubation time between 4h and 21 days. Hoarseness was a frequent symptom, starting in the first week following extubation. Histology shows mild epithelial hyperplasia, severe inflammation and vessel proliferation in the corion. Under SEM, the epithelium presented mild superficial desquamation. Under TEM, intracellular junctions showed widening with structural changes in the desmosomes. In the corion there were vessel proliferations, inflammation and fibroblasts with structural alterations. Conclusions: post intubation granulomas appear in any age and hoarseness is a frequent symptom. Morphological alterations occur in the corion as vessel proliferations, inflammation, and intracytoplasmatic alterations in fibroblasts suggesting cellular dysfunction and damage.

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Section: Discussionmentioning

confidence: 99%

Aspectos clínicos, histológicos e de microscopia eletrônica dos granulomas de intubação das pregas vocais

Martins¹,

Dias²,

Santos³

et al. 2009

Rev. Bras. Otorrinolaringol.

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“…In previous papers we reviewed the main intubation-related airway complications, which included epithelial damage caused by balloon pressure on the mucosa, 17,18 and laryngeal injury in intubated patients that cause hoarseness, such as hematomas, laceration, granulomas, and anterior and posterior commissure synechiae. 18,19 Infraglottic stenosis and airway inflammation was seen at a higher rate in children under age 5 years in our study, probably due to the reduced airway diameter.…”

Section: Discussionmentioning

confidence: 99%

Achados endoscópicos em crianças com estridor

Martins

Dias

Castilho

et al. 2006

Rev. Bras. Otorrinolaringol.

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Congeni tal and acquired airway diseases are responsible for upper respiratory distress and stridor in children. In neonatal intensive care units, we have seen increased survival in premature babies, but also a high incidence of airway complications related to intubation, which present as stridor. Aim: To review endoscopic findings in children with stridor. Study design: a cross-sectional cohort study. Methods: A retrospective analysis was done of 55 cases of children with stridor who underwent endoscopic exams, between January 1997 and December 2003. Results: 69% were aged below one year. The main indications for endoscopy were postextubation stridor (63.63%) and evaluation of neonatal stridor (21.82%). Many associated diseases were seen, including lung diseases (60%), neurological condition (45.4%), and GERD (40%). The main endoscopic findings and indications for tracheotomy were subglottic stenosis (27.27%) and airway inflammatory process (21.82%) occurring in children under five years old. Congenital disorders were more frequent in children under age one year. Conclusion: Neonatal stridor has many causes; those related to tracheal intubation are more frequent in hospitals that treat more complex diseases. Pediatricians and otorhinolaryngologists should know the main causes of stridor and perform detailed clinical evaluations to determine case severity. The endoscopic examination, must be meticulous.

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“…A intubação traumática pode ocorrer em situações de emergência ou de difícil exposição da glote, acarretando lacerações e hematomas nas pregas vocais 2 , além de luxações das cartilagens aritenóideas e desinserções musculares 12 . O tempo de permanência da cânula traqueal em contato com a mucosa da laringe e da traquéia é também importante fator na determinação das complicações das vias aéreas.…”

Section: Lesões Laríngeas: Fatores Causais E Repercussões Nas Qualidaunclassified

“…The trauma during intubation may occur in emergency situations or situations in which the glottis is hard to expose, thereby resulting in laserations and hematomas on the vocal folds, as well as luxations of the arytenoid cartilages and muscle disinsertions 12 .…”

Section: Laryngeal Lesions: Causal Factors and Repercussions In Vocalmentioning

confidence: 99%