Postintubation Injury
Postintubation Injury is a topic covered in the Pearson's General Thoracic.
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Key Points
- Blood supply to the trachea is segmental.
- Intubation may damage the airway at one or several levels: glottis, subglottis, trachea and main bronchi.
- Postintubation injury, the most common cause of benign upper airway stenosis, can be the result of pressure on the posterior commissure or vocal folds, tube cuff, tube pressure at the tracheal stoma, confluent injury between cuff and stoma in the trachea, or injury from the tip of the endotracheal tube
- Dyspnea on exertion with stridor is the usual symptom of airway stenosis. Patients are frequently misdiagnosed as having asthma.
- Critical tracheal stenosis due to intubation is best managed by tracheal or laryngotracheal resection and reconstruction in appropriate candidates.
- Repair of the arterial wall is contraindicated in acute tracheo-innominate artery fistula after tracheostomy.
- Prior to single-stage repair of tracheoesophageal fistula with tracheal resection, esophageal closure and muscle interposition, nutrition should be optimized and ongoing respiratory aspiration prevented.
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Key Points
- Blood supply to the trachea is segmental.
- Intubation may damage the airway at one or several levels: glottis, subglottis, trachea and main bronchi.
- Postintubation injury, the most common cause of benign upper airway stenosis, can be the result of pressure on the posterior commissure or vocal folds, tube cuff, tube pressure at the tracheal stoma, confluent injury between cuff and stoma in the trachea, or injury from the tip of the endotracheal tube
- Dyspnea on exertion with stridor is the usual symptom of airway stenosis. Patients are frequently misdiagnosed as having asthma.
- Critical tracheal stenosis due to intubation is best managed by tracheal or laryngotracheal resection and reconstruction in appropriate candidates.
- Repair of the arterial wall is contraindicated in acute tracheo-innominate artery fistula after tracheostomy.
- Prior to single-stage repair of tracheoesophageal fistula with tracheal resection, esophageal closure and muscle interposition, nutrition should be optimized and ongoing respiratory aspiration prevented.
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Last updated: October 26, 2022
Citation
Maddaus, Michael A, et al. "Postintubation Injury." Pearson's General Thoracic Surgery. STS Cardiothoracic Surgery E-Book, Chicago: Society of Thoracic Surgeons, 2022. STS Surgery, ebook.sts.org.
Maddaus MA, Pearson FG, Madariaga ML, Gaissert HA. Postintubation Injury. In: Darling GE, Baumgartner WA, Jacobs JP, eds. Pearson's General Thoracic Surgery. STS Cardiothoracic Surgery E-Book. Chicago: Society of Thoracic Surgeons; 2022. ebook.sts.org. Accessed March 26, 2023.
Maddaus, M. A., Pearson, F. G., Madariaga, M. L., & Gaissert, H. A. (2022). Postintubation Injury. In Darling, G., Baumgartner, W., & Jacobs, J. (Eds.), Pearson's General Thoracic Surgery. STS Cardiothoracic Surgery E-Book. Chicago: Society of Thoracic Surgeons. ebook.sts.org
Maddaus MA, Pearson FG, Madariaga ML, Gaissert HA. Postintubation Injury [Internet]. In: Darling GE, Baumgartner WA, Jacobs JP, editors. Pearson's General Thoracic Surgery. STS Cardiothoracic Surgery E-Book. Chicago: Society of Thoracic Surgeons; 2022. [cited 2023 March 26]. Available from: ebook.sts.org.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Postintubation Injury
ID - 1418450
ED - Jacobs,J,
ED - Darling,Gail,
ED - Baumgartner,William,
Y1 - 2022/10/26/
BT - Pearson's General Thoracic
UR - https://ebook.sts.org/sts/view/Pearsons-General-Thoracic/1418450/all/Postintubation_Injury
PB - Chicago: Society of Thoracic Surgeons
DB - STS Surgery
DP - Unbound Medicine
ER -