Postintubation tracheal damage. A four-year prospective study

A 4-year prospective study was undertaken to estimate the incidence and identify the pathogenesis of cuff-induced major tracheal damage. All tracheal tubes were implantation tested and the cuffs were of the high-volume low-pressure type. The cuff pressure was continuously monitored and maintained below 3kPa. During the period of the study, 684 patients were intubated. Their average age was 33.6 years (range 14-296). The average intubation period was 9.3 days (range 1-256). At first, the damage was diagnosed clinically, radiologically and then confirmed by computed tomography. Three patients (0.4%) developed lesions that were not related to excessive (CP). In this study CP control seems to have eliminated a known major cause of intubation-associated tracheal injury. To date, there is no alternative to tracheal intubation. However the laryngeal mask seems ideal if invasion of the trachea is to be avoided altogether.