The risks of tracheal intubation

Area of Science:

• Anesthesiology
• Otolaryngology
• Critical Care Medicine

Background:

• Endotracheal intubation is a common procedure for airway management and mechanical ventilation.
• Potential complications associated with intubation can affect the pharynx, larynx, and trachea.

Observation:

• A variety of lesions, ranging from minor injuries to severe conditions like stenosis and fistula, have been documented post-intubation.
• Etiologic factors include chemical irritants from tube materials/sterilization and mechanical pressure on adjacent tissues.
• Post-intubation sore throat appears unrelated to laryngoscopy trauma.

Findings:

• Mechanical and chemical properties of intubation devices are primary causes of post-intubation complications.
• Airway obstruction can occur due to tube compression or accidental blockage.
• Laryngeal and tracheal stenosis, vocal cord paralysis, and tongue paralysis are significant potential sequelae.

Implications:

• Careful selection of intubation materials and techniques can mitigate risks.
• Considering alternative airway management, such as mask anesthesia, is crucial when intubation is not essential.
• Awareness of these complications is vital for preventing and managing adverse events in intubated patients.