Detection of tongue edema caused by endotracheal intubation tube in ICU patients by ultrasonography: A prospective, observational, clinical study

Abstract

Purpose: This study aimed to detect tongue edema which may develop due to the long-term application of pressure of the endotracheal intubation (ETI) tube on the tongue using submental ultrasonography (USG). Also, we aimed to investigate the relationship between tongue edema with oxygen saturation values (SpO2) two h after extubation. Methods: A total of 100 patients aged 18–65 years, who underwent ETI and were followed up on mechanical ventilation were included. Patients (n = 57) who were followed up on mechanical ventilation for four days or longer after ETI were included in the study group. Those who were followed up on mechanical ventilation for three days or less after ETI were included in the control group (n = 43). The tongue cross-sectional areas (TSAs) of patients in both groups were measured twice with submental USG. The first measurement (TSA1) was performed on the 0th day of ETI in all patients in both groups. The second measurement (TSA2) was performed on the 4th day of ETI in the study group and just before extubation in the control group. The difference between TSA2 and TSA1 was defined as tongue edema. Results: The tongue edema was more prevalent in the study group (p = 0.000). The SpO2 values two h after extubation were lower in patients with tongue edema than those without tongue edema (p = 0.000). Conclusions: Tongue edema may develop due to the long-term application of pressure of the ETI tube on the tongue and may impair oxygenation after extubation. ClinicalTrials.gov Identifier: NCT05249738