Prolonged Endotracheal Intubation

Pecora, David V.; Seinige, Ursula

doi:10.1378/chest.82.1.130a

“…Because several studies have shown that endoscopic examination of the upper airway in patients with translaryngeal intubation have demonstrated evidence of upper airway injuries in up to 65% of patients [21,24,25,33], some authors have recommended converting a patient to a tracheostomy if they have endoscopic evidence of upper airway injury [33]. However, other studies have demonstrated a poor predictive value of endoscopy in assessing for the risks of long-term laryngeal complications [26,34,35].…”

Section: Tracheostomiesmentioning

confidence: 99%

Tracheostomy in the ICU

Conlan

¹

,

Kopec

²

2000

J Intensive Care Med

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The placement of a tracheostomy has become a routine procedure for intensive care unit patients who are mechanical ventilator dependent for a period of time, usually exceeding 1 or 2 weeks. It is vital for the intensivist to be familiar with all aspects of tracheostomies care including the timing of converting a patient to a tracheostomy, types of procedure, risks and benefits, and issues of daily care including oral feedings, speech, and decannulation. In this article we provide a comprehensive review for the intensivist regarding tracheostomies in the intensive care setting. We specifically review indications, timing, surgical options including percutaneous dilation tracheostomy, complications, decannulation, oral feeding, speaking devises, stomal stents, and routine tracheostomy care.

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“…Because several studies have shown that endoscopic examination of the upper airway in patients with translaryngeal intubation have demonstrated evidence of upper airway injuries in up to 65% of patients [21,24,25,33], some authors have recommended converting a patient to a tracheostomy if they have endoscopic evidence of upper airway injury [33]. However, other studies have demonstrated a poor predictive value of endoscopy in assessing for the risks of long‐term laryngeal complications [26,34,35].…”

Section: Timing Of Tracheostomymentioning

confidence: 99%

Tracheostomy in the ICU

Conlan¹,

Kopec²

2000

J Intensive Care Med

8

0

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The placement of a tracheostomy has become a routine procedure for intensive care unit patients who are mechanical ventilator dependent for a period of time, usually exceeding 1 or 2 weeks. It is vital for the intensivist to be familiar with all aspects of tracheostomies care including the timing of converting a patient to a tracheostomy, types of procedure, risks and benefits, and issues of daily care including oral feedings, speech, and decannulation. In this article we provide a comprehensive review for the intensivist regarding tracheostomies in the intensive care setting. We specifically review indications, timing, surgical options including percutaneous dilation tracheostomy, complications, decannulation, oral feeding, speaking devises, stomal stents, and routine tracheostomy care.

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“…[86], but tended to be a manageable problem. Several authors [42,85] stated that the larynx tolerates TLI well, with few serious clinical complications, for periods of up to 2 to 3 weeks. These observations reiterate the important point that there is a poor correlation between the extent of laryngeal damage caused by TLI and the subsequent clinical complications.…”

Section: Historical Developmentmentioning

confidence: 99%

“…Although some studies suggested that TLI-induced laryngeal problems increase with the length of TLI [81,82,102], the majority of investigators found no clear relationship between TLI duration and subsequent laryngeal complications [41,42,77,79,84,85]. It has been shown that despite laryngeal mucosal injury there is a low incidence of serious or chronic laryngeal problems following TLI for periods of 2 weeks or longer [42,44,85]. Conversely, TLI for periods as short as hours may be associated with postextubation upper airway obstruction or chronic laryngeal granulomas and fibrosis.…”

Section: Historical Developmentmentioning

confidence: 99%

Prolonged Intubation Versus Tracheostomy in the Adult

Colice

¹

1987

J Intensive Care Med

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The development of mechanical ventilators that can en sure adequate respiration for long periods of time has led to the problem of determining how to best integrate patients into the machine's airflow circuits. Tracheal tubes with inflatable cuffs efficiently connect the patient to the machine, but the tubes may be placed in one of two ways. Each option has relative advantages and disad vantages. Translaryngeal intubation (TLI) can be per formed safety and quickly and is the preferred first step in airway management. However, when TLI is needed for prolonged periods, it may damage the larynx. Tra cheostomy, on the otherhand, has potential operative and tracheal complications, but presents little risk to the larynx and may be better tolerated by the patient requir ing long-term intubation. This review provides a histor ical background of these two methods and analyzes their respective advantages and complications. Guide lines for the optimal use of TLI and tracheostomy, par ticularly in adult patients requiring long-term intuba tion, are developed by comparing the risks and benefits of these two methods.

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Prolonged Endotracheal Intubation

Cited by 9 publications

References 4 publications

Tracheostomy in the ICU

Tracheostomy in the ICU

Tracheostomy in the ICU

Prolonged Intubation Versus Tracheostomy in the Adult

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