Evaluation of laryngotracheal alterations associated with intubation

Background: Laryngeal injuries following intubation have a reported incidence from 63 to 94% and permanent sequelae are reported to be about 10 to 22% in the world literature. While several studies assessing the laryngeal complications are available in Western populations, minimal data is available in the literature regarding Indian population. Aim: The aim of this study is to evaluate laryngeal lesions in patients after prolonged intubation (>24 h), to correlate these lesions with the variables involved in the process of intubation and to determine the risk factors. Materials and Methods: The study was undertaken at the ICU of a Tertiary Care Hospital. AU patients extubated at the intensive care unit of our hospital after at least 24 h of intubation were included in the study. Fibreoptic Bronchoscopy was done on day of extubation, and weekly for 03 weeks. Result: 100 patients were included in the study. Laryngeal abnormalities were seen in 88 patients on the day of extubation. At the end of third week after extubation, only 09 patients had abnormal laryngeal findings. A multivariate stepwise regression model showed that bigger tube size and longer duration of intubation was associated with higher incidence of laryngeal complications on the day of extubation. At the end of third week laryngeal findings were influenced only by the duration of intubation and size of Endotracheal tube. Conclusion: Laryngeal alterations after extubation are directly associated with duration of intubation and size of Endotracheal tube