Laryngeal complications after endotracheal intubation and prone positioning in patients with coronavirus disease 2019

Aibara, Shiori; Okada, Masahiro; Tanaka-Nishikubo, Kaori; Asayama, Rie; Sato, Eriko; Sei, Hirofumi; Aoishi, Kunihide; Takagi, Toshiharu; Teraoka, Masato; Mukai, Naoki; Konishi, Saki; Okita, Mitsuo; Ogawa, Siro; Annen, Suguru; Ohshita, Muneaki; Matsumoto, Hironori; Murata, Satoru; Harima, Yutaka; Kikuchi, Satoshi; Takeba, Jun; Sato, Norio; Hato, Naohito

doi:10.1002/lio2.874

Cited by 4 publications

(1 citation statement)

References 27 publications

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“…In our study, tracheostomy was delayed in 100% of cases (beyond 7 days) with an average of 16.35 days. This could be one of the hypotheses for the appearance of more lesions after intubation in this type of patient than in others intubated for another pathology in other periods outside the COVID-19 pandemic ( Table 6 ) [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 23 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 ].…”

Section: Discussionmentioning

confidence: 96%

Laryngotracheal Complications after Intubation for COVID-19: A Multicenter Study

Hernández-García,

Hernández-Sandemetrio,

Quintana-Sanjuás

et al. 2023

Life

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Many of the patients with COVID-19 have suffered respiratory distress requiring prolonged endotracheal intubation (ETI) resulting in laryngotracheal complication with an impact on breathing, phonation, and swallowing. Our aim is to describe laryngeal injuries diagnosed after ETI in patients with COVID-19 in a multicentre study. Methods: A prospective descriptive observational study was conducted from January 2021 to December 2021, including COVID-19 patients with laryngeal complications due to ETI diagnosed in several Spanish hospitals. We analyzed the epidemiological data, previous comorbidities, mean time to ICU admission and ETI, need for tracheostomy, mean time on invasive mechanical ventilation until tracheostomy or weaning, mean time in ICU, type of residual lesions, and their treatment. Results: We obtained the collaboration of nine hospitals during the months of January 2021 to December 2021. A total of 49 patients were referred. Tracheostomy was performed in 44.9%, being late in most cases (more than 7–10 days). The mean number of days of ETI until extubation was 17.63 days, and the main post-intubation symptoms were dysphonia, dyspnea, and dysphagia, in 87.8%, 34.7%, and 42.9%, respectively. The most frequent injury was altered laryngeal mobility, present in 79.6%. Statistically, there is a greater amount of stenosis after late ETI and after delayed tracheostomy, not observing the data with the immobility alterations. Conclusion: The mean number of days of ETI was long, according to the latest guidelines, with the need for several cycles of pronation. This long ETI may have had an impact on the increase of subsequent laryngeal sequelae, such as altered laryngeal mobility or stenosis.

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Section: Discussionmentioning

confidence: 96%

Laryngotracheal Complications after Intubation for COVID-19: A Multicenter Study

Hernández-García,

Hernández-Sandemetrio,

Quintana-Sanjuás

et al. 2023

Life

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Drug delivery systems for wound healing treatment of upper airway injury

Cruz,

Zheng,

Debele

et al. 2024

Expert Opinion on Drug Delivery

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Effect of thermal softening of double-lumen endobronchial tubes on postoperative sore throat in patients with prior SARS-CoV-2 infection: a randomized controlled trial

Yan,

Cai,

Zhu

et al. 2023

BMC Anesthesiol

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Background The incidence of postoperative sore throat (POST) after tracheal intubation using double-lumen endobronchial tubes (DLTs) is higher in patients with prior severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection than in the general population. This prospective trial was conducted to determine whether thermal softening of DLTs could decrease the incidence of POST or other airway injuries in patients with prior SARS-CoV-2 infection. Methods A total of 120 patients with prior SARS-CoV-2 infection undergoing thoracoscopic surgery were randomly assigned to two groups (n = 60 each). In the thermal softening group, the distal portion of the DLT was placed in thermostatic saline (50 °C) for 10 min before endotracheal intubation. In the control group, the distal portion of the DLT was placed in room temperature saline for 10 min before endotracheal intubation. The incidence and severity of POST and hoarseness were assessed at 1, 6 and 24 h postoperatively. The primary outcomes were the incidence and severity of POST at 6 h postoperatively. The secondary outcomes were the incidence and severity of hoarseness, vocal cord and tracheal injuries, and hemodynamic changes in patients at intubation. Results The incidence of POST at 6 h postoperatively was greater in the control group than in the thermal softening group [41 (68%) vs. 22 (37%), P = 0.001]. The overall incidence of POST at 24 h postoperatively was greater in the control group than in the thermal softening group [46 (76%) vs. 24 (40%), P < 0.001]. The overall incidence of tracheal injuries was also greater in the control group than in the thermal softening group (P = 0.016). Vocal cord injuries occurred more frequently in the control group than in the thermal softening group (P = 0.006). Conclusion Thermal softening of DLTs before intubation can reduce the incidence of POST and airway injuries in patients with prior SARS-CoV-2 infection undergoing DLT insertion. Trial registration This trial has been registered at www.chictr.org.cn (registration number: ChiCTR2200066821; registration date: December 19, 2022).

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Laryngeal complications after endotracheal intubation and prone positioning in patients with coronavirus disease 2019

Cited by 4 publications

References 27 publications

Laryngotracheal Complications after Intubation for COVID-19: A Multicenter Study

Laryngotracheal Complications after Intubation for COVID-19: A Multicenter Study

Drug delivery systems for wound healing treatment of upper airway injury

Effect of thermal softening of double-lumen endobronchial tubes on postoperative sore throat in patients with prior SARS-CoV-2 infection: a randomized controlled trial

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