Keywords : LTI
A prospective clinical assessment of the laryngotracheal injuries following endotracheal intubation
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 5, Pages 301-307
Aim: The aim of the present study to evaluate thelaryngotracheal injuries following endotracheal intubation.
Methods: A prospective study was conducted in the Department of Otorhinolaryngology, RVM Institute of Medical Sciences & Research Centre, Laxmakkapally, Telangana, India for the period of 1 year. 50 Patients intubated for more than 48 hours and admitted in medical ICU and aged more than 15 years were included in this study. To find the incidence, types of injury and to study the factors influencing LTI following intubation.
Results: Of 50, 32 were males and 18 were females with age ranging from 15 to 70 years. Majority of patients (70%) were between 15-29 years. Endotracheal tube of size 7.5 and 8 were used in 84% of patients. Majority of the patients (52%) were cases of organophosphorus (OP) poisoning followed by metabolic disorders like diabetic ketoacidosis and chronic kidney disease with encephalopathy. 36% of the patients were intubated for more than 10 days. The x-ray was normal in 36 patients (72%) while the abnormality was picked up in 14 (28%) patients. On 70-degree endoscopy, 4 patients (8%) had granulation tissue in the posterior commissure and one patient had bilateral vocal cord fixation. All the patients who had LTI were aged less than 45 years and 16 of 20 cases affected were males. Among the cases of LTI, 16 (80%) out of 20 cases were intubated with endotracheal tubes of size more than 7. 12 (60%) of the total cases of LTI had intubation for more than 10 days. OP poisoning was the etiology for LTI in 16 cases (80%).
Conclusion: A high incidence of LTI especially in cases of OP poisoning warrants one to be cautious in managing these intubated patients. Those patients requiring prolonged intubation should be considered for other alternative airway managements like tracheostomy in addition to using low pressure, high volume cuffed tubes