Laryngeal sequelae following prolonged intubation: A prospective study

Abstract

Background: Laryngeal injuries following intubation have a reported incidence from 63 to 94% and permanent sequelae are reported to be about 10 to 22% in the world literature. While several studies assessing the laryngeal complications are available in Caucasoid populations, minimal data is available in the literature regarding south Indian population. Aim: The aim of this study was to evaluate laryngeal lesions in patients after prolonged intubation (>24 h), to correlate these lesions with the variables involved in the process of intubation and to determine the risk factors. Materials and Methods: This is a prospective study for 1 year of patients who were intubated for more than 24 h in our critical care unit. Patients underwent laryngeal video endoscopy on the day of extubation and after 3 weeks by an ENT surgeon who was blinded to the intubation variables. Result: About 51 patients were included in the study. Laryngeal abnormalities were seen in 41 patients on the day of extubation. At the end of third week after extubation, only 10 patients had abnormal laryngeal findings. A multivariate stepwise regression model showed that bigger tube size (P=0.02), longer duration of intubation (P=0.01) and emergency intubation (P= 0.02) was associated with higher incidence of laryngeal complications on the day of extubation. At the end of third week laryngeal findings were influenced only by the duration of intubation (P=0.001). Conclusion: Laryngeal sequelae after extubation is directly associated with duration of intubation.

Management of Laryngotracheal Stenosis: A 10-Year Study on the Role of Stents

“…26 There was an alarming increase in the incidence of LTS especially in children following endotracheal intubation which Othersen called it "a new epidemic." 27 The reported incidence of laryngotracheal injuries following endotracheal intubation varied from 62 8 to 94% for temporary laryngeal injuries 28 and 10 to 20% of these result in permanent laryngeal sequelae such as LTS. The incidence of laryngotracheal injuries reportedly had reduced after the use of "high-volume low-pressure cuffed endotracheal tubes."…”

Uzun süreli entübasyon yapılmış hastalarda laringofaringeal etkilerin değerlendirilmesi

“…Mann-Whitney U test or independent sample t test was used between two groups, and analysis of variance was used to assess the significance of differences among 3 groups as appropriate. We enrolled patients scheduled for cardiac surgery due to the lengthy intubation involved during surgery and during monitoring in intensive care [10][11][12]. We observed correlation between total length of intubation and effects in laryngopharyngeal structures.…”

“…Various postoperative complications are seen in patients undergoing cardiac surgery, particularly vocal cord paralysis associated with recurrent laryngeal and vagal nerve trauma, and these complications may result in prolongation of intubation and of stay in intensive care [9][10][11][12]. We determined vocal cord paralysis in one case, but the patient was referred for clinical follow-up since the respiratory functions were not affected.…”

Role of Topical Medication in Prevention of Post-extubation Subglottic Stenosis

“…It has been reported that temporary LTI occurred in 62-94% of intubations [8]. A number of factor influence the severity of injury and the progress to formation of SGS.…”