Postintubation tracheal damage: a four year prospective study

ABSTRACT

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 14-96].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