Prospective Studies Evaluating the Standard Endotracheal Tube and a Prototype Endotracheal Tube

Abstract

Two prospective studies were designed to evaluate laryngeal injury sustained with the standard endotracheal tube (ETT) and the relative safety of a new prototype ETT. The first study followed patients after prolonged intubation with the standard ETT. Potential patient host factors were recorded and correlated with subjective complaints and objective findings on fiberoptic laryngoscopy. Nearly all patients sustained laryngeal injury after prolonged intubation, although over two thirds experienced resolution. Nasogastric feeding tubes and larger-diameter ETTs were associated with true vocal cord (TVC) granuloma formation. Duration of intubation was associated with delayed TVC immobility. The mechanisms of TVC granulomas and immobility are probably different, as suggested by the different host factor associations and onset times. The second study compared the standard ETT with the prototype ETT in short-term intubations. The prototype ETT was associated with no complications in this setting and is considered relatively safe for further testing in the patient with prolonged intubation.

Dyspnoea in a patient with chronic heart failure: surprise, surpise!

“…Females account for >75% of reported cases 4. The size, composition and shape of the endotracheal tube is considered the most important factor causing laryngeal trauma 5. The majority of the granulomas seen resolved between 8 and 14 weeks (average of 4 weeks) after extubation.…”

Lesões crônicas da laringe pela intubação traqueal

“…Kastanos et al (10) relataram 63 % de disfonia, incluído um doente cuja disfonia permaneceu por um ano sem lesão identificável na laringoscopia. Santos et al (14) encontraram disfonia em 80% dos pacientes, sendo que 20% permaneceram disfônicos por oito semanas.…”

“…Alguns fatores são sugeridos como predisponentes para a formação de granuloma: a idade adulta, sexo feminino, estetoscópios esofágicos, anemia, hipotensão, desnutrição, infecção respiratória, diabete melito e outros semelhantes aos fatores predisponentes e/ou desencadeantes de modo geral (14,24) . Nesta série, não encontramos rela-J Pneumol 27(2) -mar-abr de 2001 ção entre esses fatores e o desenvolvimento de granuloma da laringe.…”

Complicações laringeas por intubação orotraqueal: Revisão da literatura

“…Alguns fatores são sugeridos para a formação de granuloma: a idade adulta, gênero feminino, anemia, hipotensão, desnutrição, infecção respiratória, diabetes mellitus e outros semelhantes aos fatores predisponentes e/ou desencadeantes de modo geral (18,19).…”