Early laryngeal injury and complications because of endotracheal intubation in acutely poisoned patients: a prospective observational study

Mégarbane, Bruno; Hong, Thu Be; Kania, Romain; Herman, Philippe; Baud, Frédéric J.

doi:10.3109/15563651003801117

Cited by 14 publications

(30 citation statements)

References 26 publications

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“…Of these, 9 studies from 5 countries were accepted with the focus on laryngeal injury from oral endotracheal intubation in mechanically ventilated ICU patients (Figure 1). These 9 studies comprised 7 cohort studies (663 patients) [33][34][35][36][37][38][39] and 2 crosssectional studies (112 patients), 40,41 totaling 775 patients (Table 1).…”

Section: Search Resultsmentioning

confidence: 99%

“…Eight studies had laryngeal injury after oral intubation as the primary objective, [34][35][36][37]40 whereas one study had frequency of dysphagia post-extubation as its primary objective. 41 Patients' mean (SD; 95% confidence interval [95%CI]) age was 53.4 (7.0; 52.8-54.0) years across the 8 (89%) studies reporting age.…”

Section: Clinical Presentationmentioning

confidence: 99%

“…41 Patients' mean (SD; 95% confidence interval [95%CI]) age was 53.4 (7.0; 52.8-54.0) years across the 8 (89%) studies reporting age. [33][34][35][36][37][38]40,41 Diagnoses included cardiac, 38,41 medical, 33,34,36,[38][39][40][41] mixed medical-surgical, 40 oncological, 38,41 surgical, [39][40][41] nonneurological trauma, 41 and unclear/unstated diagnoses. 35,37,41 Whereas 6 (67%) studies reported endotracheal tube (ETT) size, [33][34][35][36]40,41 only 1 (11%) study distinguished ETT size between the sexes, with most females receiving a 7.0 mm inner diameter (range: 6.5-7.0 mm) compared with most males receiving an 8.0 mm inner diameter (range: 7.5-8 mm).…”

Section: Clinical Presentationmentioning

confidence: 99%

“…35,37,41 Whereas 6 (67%) studies reported endotracheal tube (ETT) size, [33][34][35][36]40,41 only 1 (11%) study distinguished ETT size between the sexes, with most females receiving a 7.0 mm inner diameter (range: 6.5-7.0 mm) compared with most males receiving an 8.0 mm inner diameter (range: 7.5-8 mm). 34 Two (22%) studies reported ETT manufacturer. 33,36 Across 7 (78%) studies, the calculated mean (SD; 95%CI) duration of intubation was 8.2 (6.0; 7.7-8.7) days.…”

Section: Clinical Presentationmentioning

confidence: 99%

“…33,36 Across 7 (78%) studies, the calculated mean (SD; 95%CI) duration of intubation was 8.2 (6.0; 7.7-8.7) days. 33,34,[36][37][38]40,41 One (11%) study reported median duration of 4 days, but without any measure of variability 35 and one study reported 3 groups with ranges of intubation duration without summary statistics 39 (Table 1).…”

Section: Clinical Presentationmentioning

confidence: 99%

See 4 more Smart Citations

Laryngeal Injury and Upper Airway Symptoms After Oral Endotracheal Intubation With Mechanical Ventilation During Critical Care: A Systematic Review*

Brodsky

Levy

Jedlanek

et al. 2018

Critical Care Medicine

225

216

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Laryngeal injury from intubation is common in the ICU setting. Guidelines for laryngeal assessment and postextubation surveillance do not exist. A systematic approach to more robust investigations could increase knowledge of the association between particular injuries and corresponding functional impairments, improving understanding of both time course and prognosis for resolution of injury. Our findings identify targets for future research and highlight the long-known, but understudied, clinical outcomes from endotracheal intubation with mechanical ventilation in ICU.

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Section: Search Resultsmentioning

confidence: 99%

Section: Clinical Presentationmentioning

confidence: 99%

Section: Clinical Presentationmentioning

confidence: 99%

Section: Clinical Presentationmentioning

confidence: 99%

Section: Clinical Presentationmentioning

confidence: 99%

See 3 more Smart Citations

Laryngeal Injury and Upper Airway Symptoms After Oral Endotracheal Intubation With Mechanical Ventilation During Critical Care: A Systematic Review*

Brodsky

Levy

Jedlanek

et al. 2018

Critical Care Medicine

225

216

View full text Add to dashboard Cite

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Acute Laryngeal Injury in Patients Undergoing Airway Screening at a Long‐Term Acute Care Hospital

Pagel,

Taffe,

Jonas

et al. 2024

The Laryngoscope

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Background/ObjectivesAcute laryngeal injury (ALgI) is an identified complication of prolonged intubation. Its evolution into mature stenosis and factors affecting decannulation are unclear. This retrospective review aims to characterize the incidence and characteristics of ALgI development and decannulation.MethodsRetrospective study of post‐intubated patients with a tracheostomy seen for screening evaluation at a single long‐term acute care hospital (LTACH) from 2019 to 2022.ResultsPatients were followed for an average of 115 days after extubation. Forty‐nine of 119 adult patients had ALgI. Those with ALgI were more likely female (61% vs. 35.7%, p = 0.006) with higher body mass index (BMI; 32.9 vs. 28.1, p = 0.03) and lower height (166 vs. 171.1 cm, p = 0.01). Decannulation rates in patients with ALgI were 69.4% compared to 84.3% in patients without ALgI (p = 0.053). Patients with ALgI were scoped more quickly post‐extubation (28.8 vs. 36.6 days, p = 0.04), but time to decannulation did not differ (66.6 vs. 81.2 days, p = 0.74). Lower CCI (4.03 vs 6.93) and lack of tobacco use (41.2% vs 73.3%) were associated with successful decannulation (p = 0.038, p = 0.0008). Patients with ALgI treated conservatively (observation or medical management) were decannulated up to 71 days post‐extubation. Further decannulations only occurred with surgical intervention.ConclusionsFemale gender, higher BMI, and shorter height are associated with ALgI among patients undergoing a LTACH screening evaluation. CCI and tobacco have a negative association with decannulation success. Among the ALgI cohort, no patient treated conservatively was decannulated after 71 days.Level of Evidence4 Laryngoscope, 2024

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Dysphagia in patients with coronavirus disease undergoing orotracheal intubation

Almeida

Félix

Tavares

et al. 2022

Laryngoscope Investig Oto

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Objective To assess the incidence and the risk factors for the development of dysphagia in patients with coronavirus disease 2019 (COVID‐19) undergoing orotracheal intubation. Study Design Prospective cohort study. Methods In this prospective cohort study, we evaluated consecutive patients diagnosed with COVID‐19 and underwent orotracheal intubation were evaluated. During hospitalization, extubated patients were classified as dysphagic and nondysphagic based on bedside functional assessment of swallowing. Patients discharged from hospital were asked to complete the Eating Assessment Tool‐10 (EAT‐10) questionnaire, followed by an endoscopic examination to identify laryngotracheal lesions, and a fiberoptic endoscopic evaluation of swallowing (FEES). The food consistencies used for FEES were moderately thick, extremely thick, thin, and regular. Results Based on the functional assessment of swallowing, performed a mean of 5.3 days and a median of 4 days after extubation, the incidence of dysphagia in patients with COVID‐19 undergoing orotracheal intubation was 53.6%. In the late evaluation, performed a mean of 102 days after extubation, 12.8% of patients had an EAT‐10 score >2. Orotracheal intubation (OTI) duration and tracheostomy were risk factors for the development of dysphagia. There was an association between EAT‐10 > 2 and the presence of laryngotracheal lesion, with no difference between lesion type and EAT score >2. Conclusions The incidence of dysphagia varied according to the time of assessment, being higher the earlier the assessment after extubation. OTI duration and tracheostomy were risk factors for the development of dysphagia, and the presence of laryngotracheal lesions demonstrated an association with dysphagia. Level of Evidence 3.

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Early laryngeal injury and complications because of endotracheal intubation in acutely poisoned patients: a prospective observational study

Abstract: Despite short-duration intubation, poisoned patients are at high risk of initial laryngeal injury.

Cited by 14 publications

References 26 publications

Laryngeal Injury and Upper Airway Symptoms After Oral Endotracheal Intubation With Mechanical Ventilation During Critical Care: A Systematic Review*

Laryngeal Injury and Upper Airway Symptoms After Oral Endotracheal Intubation With Mechanical Ventilation During Critical Care: A Systematic Review*

Acute Laryngeal Injury in Patients Undergoing Airway Screening at a Long‐Term Acute Care Hospital

Dysphagia in patients with coronavirus disease undergoing orotracheal intubation

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