Archive for the 'Laryngeal Complications' Category

05 Jan

Laryngeal Complications of Prolonged Intubation: Conclusion

Initial intubation tended to result from an exacerbation of either chronic respiratory or cardiac disease. Few young, previously healthy patients with acute, catastrophic respiratory failure were included. The effect of these demographic characteristics on our findings were probably minimal, though, because age and serum albumin (an indirect marker of chronic illness) were not significantly associated […]

04 Jan

Laryngeal Complications of Prolonged Intubation: Outcome

The TLI-induced laryngeal dysfunction may predispose patients to aspiration postextubation. Whited has described bilateral symmetric vocal cord paresis with paramedian positioning postextubation, possibly due to edema, ulcerations and inflammation of the larynx limiting motor function. The translaryngeal tube may also cause a sensory denervation of the larynx and hypopharynx by constant pressure. Sensory denervation compromises […]

03 Jan

Laryngeal Complications of Prolonged Intubation: Mucociliary clearance mechanisms

The normal mucociliary clearance mechanisms will carry bacteria entering the tracheal stoma cephalad, towards the larynx previously damaged by TLI. Because our initial laryngoscopies were performed up to 24 hours after tracheostomy, secondary bacterial infection of the injured larynx might have exacerbated pre-existing laryngeal pathology. These points suggest that abrasion of the larynx by the […]

02 Jan

Laryngeal Complications of Prolonged Intubation: Discussion

This prospective study of patients experiencing TLI for more than four continuous days confirms earlier reports on the incidence of transient and chronic- hoarseness postextubation. Chronic hoarseness may develop because of either vocal cord granulomas developing at the site of TLI-induced ulcerations or laryngeal stenosis. All four patients with chronic hoarseness in this series were […]

01 Jan

Laryngeal Complications of Prolonged Intubation: Adverse Effects

Table 5 shows the proportion of patients with severe adverse effects and with chronic hoarseness alone by levels of initial laryngeal pathology. About 7 percent of patients developed chronic hoarseness independent of their initial pathology (relative risk =1.1; p>0.8). Patients with no or mild initial pathology did not develop severe adverse effects. Moderate and severe […]

05 Dec

Laryngeal Complications of Prolonged Intubation: Initial Laryngeal Damage

The univariate relative risks of moderate or severe initial laryngeal damage for each baseline variable are reported in Table 3. Risks were higher for patients with longer duration of TLI and for those undergoing tracheostomy, and lower for the five patients identified as having flaccid paralysis throughout the duration of TLI (one following massive stroke, […]

04 Dec

Laryngeal Complications of Prolonged Intubation: Results

Eighty-six patients met the entry criteria for this study. Four patients were excluded: one refused to enter the study, one was not entered because high grade ventricular ectopy prevented laryngoscopy, and two had incomplete records. The 82 study patients were all men with a mean age of 64.3 ±1.2 (SEM) years (range, 25 to 88 […]

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