Changes in Larynx and Trachea in Postintubated Patients

Abstract

Present critical care units have a significant number of patients who require intubation for prolonged periods of time. With the advent of high volume low-pressure tubes, it is common for the patients to be ventilated through the endotracheal tube for up to 3 weeks in the ICU. The sequelae of intubation depend on multiple factors and can also at times be a major source of morbidity to the patient during recovery. Laryngeal complications after prolonged intubations have varied incidence rates in the literature. Hoarseness of voice, cough, dysphagia, aspiration and stridor can develop after extubation. Common injuries following long-term intubation can manifest in the form of edema, ulceration, granulomas, arytenoid dislocations, adhesions, subglottic stenosis and vocal fold immobility, etc. This study conducted in our ENT Department is based on cases with changes in larynx and trachea following prolonged intubation in Intensive Care Units of Government General Hospital, attached to Rangaraya Medical College, Kakinada, during a period of about two years (September 2011 to August 2013. In our study, 20 patients (66.67%) had lesions only in larynx and 10 patients (33.33%) had lesions in both larynx and trachea. Laryngotracheal sequelae in long-term intubation which showed the increased incidence of complications in patients with more than 10-14 days intubation.