Effect of two regimens of fluid administration on airway edema in prone-position surgery

Jan, Ravees; AlAhdal, Ayman Mohammad; Bithal, Parmod K.

doi:10.4103/aer.aer_89_20

Cited by 1 publication

(1 citation statement)

References 22 publications

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“…In addition, the tracheal-bronchial secretions are relevant indicators of laryngeal edema because they are triggered simultaneously, and both are caused by airway inflammation 45 . Furthermore, acute venous congestion due to excessive fluid infusion could increase pulmonary congestion causing tracheal-bronchial secretions 46 , 47 ; moreover, it could also increase the risk of laryngeal edema 48 . Subsequently, the procedure of endotracheal suctioning itself has been reported to potentially cause tracheal-bronchial inflammation 49 , 50 and pulmonary edema 51 .…”

Section: Discussionmentioning

confidence: 99%

Predictors of post-extubation stridor in patients on mechanical ventilation: a prospective observational study

Tanaka

Uchiyama

Horiguchi

et al. 2021

Sci Rep

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The cuff leak test (CLT) has been widely accepted as a simple and noninvasive method for predicting post-extubation stridor (PES). However, its accuracy and clinical impact remain uncertain. We aimed to evaluate the reliability of CLT and to assess the impact of pre-extubation variables on the incidence of PES. A prospective observational study was performed on adult critically ill patients who required mechanical ventilation for more than 24 h. Patients were extubated after the successful spontaneous breathing trial, and CLT was conducted before extubation. Of the 191 patients studied, 26 (13.6%) were deemed positive through CLT. PES developed in 19 patients (9.9%) and resulted in a higher reintubation rate (8.1% vs. 52.6%, p < 0.001) and longer intensive care unit stay (8 [4.5–14] vs. 12 [8–30.5] days, p = 0.01) than patients without PES. The incidence of PES and post-extubation outcomes were similar in patients with both positive and negative CLT results. Compared with patients without PES, patients with PES had longer durations of endotracheal intubation and required endotracheal suctioning more frequently during the 24-h period prior to extubation. After adjusting for confounding factors, frequent endotracheal suctioning more than 15 times per day was associated with an adjusted odds ratio of 2.97 (95% confidence interval, 1.01–8.77) for PES. In conclusion, frequent endotracheal suctioning before extubation was a significant PES predictor in critically ill patients. Further investigations of its impact on the incidence of PES and patient outcomes are warranted.

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