Determinants of Tracheal Injury by Cuffed Tracheostomy Tubes

Dunn, C. Richard; Dunn, Deon L.; Moser, Kenneth Μ.; Moser,

doi:10.1378/chest.65.2.128

Cited by 45 publications

(27 citation statements)

References 16 publications

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“…These include: size of tube relative to airway size (McGinnis et a1 1974) and duration of intubation (Dobrin and Canfield 1977;Stauffer, Olson and Petty 1981;Whited 1984). Tube movement (Connady et al 1976) and tube cuff pressure may also be important (Dobrin and Canfield 1977;Dunn, Dunn and Moser 1974;Loeser et a1 1976;Seegobin and van Hasselt 1984).…”

Section: Discussionmentioning

confidence: 99%

Laryngotracheal lesions following routine orotracheal intubation in the horse

Heath

Steffey

et al. 1989

Equine Veterinary Journal

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Summary Sequelae of routine orotracheal intubation under clinical conditions were characterised in 38 healthy horses presented at three veterinary medical teaching hospitals. Four of these were necropsied and their tissues studied histologically. To minimise variation, 30 mm id cuffed silicone endotracheal tubes or Cole cuffless tubes were used in all patients. Fibreoptic endoscopic examination of upper respiratory and tracheal areas was accomplished pre‐intubation, immediately post extubation and after 24 h. Endoscopy revealed that intubation was associated with laryngeal and/or tracheal lesions in all horses. Observations included abundant tracheal mucus, epithelial ecchymoses, basement membrane haemorrhage and mucus covered diphtheritic membrane plaques. Histological examination of lesions from the upper respiratory system of the four necropsied horses confirmed that the damage was comparable to that associated with tracheal intubation and reported in other species.

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Section: Discussionmentioning

confidence: 99%

Laryngotracheal lesions following routine orotracheal intubation in the horse

Heath

Steffey

et al. 1989

Equine Veterinary Journal

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“…The mechanism of tracheal stenosis after cuff over inflation has been extensively studied in human medicine 23–26 . Leigh and Maynard 25 concluded that exerting pressure on tracheal mucosa greater than the capillary perfusion pressure of tracheal blood vessels will lead to ischemic damage (the lateral wall pressure from the inflated cuff should be <20 mm Hg) 25 .…”

Section: Discussionmentioning

confidence: 99%

Intraluminal Tracheal Stenting for Treatment of Tracheal Narrowing in Three Cats

et al. 2007

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“…In other species, risk factors associated with tracheal lesions include the size of the ET tube relative to airway size, 2 duration of intubation, [3][4][5] ET tube movement 6 and ET tube cuff pressure. 3,[7][8][9] Over inflation of ET tube cuffs may result in tracheal lesions. 3,[7][8][9] Movement of the ETcuff and/or overinflation of the cuff may explain the severe tracheal lesions in this horse.…”

Section: Discussionmentioning

confidence: 99%

Pleuropneumonia as a sequela of myelography and general anaesthesia in a Thoroughbred colt

et al. 2006

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A 3-year-old Thoroughbred colt was presented to the University Veterinary Centre Camden for evaluation of ataxia. The horse was anaesthetised to facilitate cervical radiography and myelographic examination of the spinal cord. Recovery from anaesthesia was uneventful. Five days after general anaesthesia the horse re-presented with pleuropneumonia. It was euthanased 24 hours after presentation on humane grounds. Necropsy revealed severe tracheal erosion over the middle third of the ventral surface of the trachea, pleuropneumonia and narrowing of the cervical cord between C4 and C6. It is postulated that extension and flexion of the neck during myelography resulted in movement of the endotracheal tube cuff, causing the tracheal lesion and predisposing the colt to pleuropneumonia. Severe tracheal lesions and pleuropneumonia have not been reported as sequela of equine myelography, and should be considered as possible complications following repeated cervical manipulation during myelography in the horse.

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Determinants of Tracheal Injury by Cuffed Tracheostomy Tubes

Cited by 45 publications

References 16 publications

Laryngotracheal lesions following routine orotracheal intubation in the horse

Laryngotracheal lesions following routine orotracheal intubation in the horse

Intraluminal Tracheal Stenting for Treatment of Tracheal Narrowing in Three Cats

Pleuropneumonia as a sequela of myelography and general anaesthesia in a Thoroughbred colt

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