ArticleAnnals of intensive care2017
Incidence of airway complications in patients using endotracheal tubes with continuous aspiration of subglottic secretions.
Article in Annals of intensive care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 21 citations in OpenAlex.
- Risk factors for extubation-related complications in morbidly obese patients undergoing bariatric surgery: a retrospective cohort study.Journal of anesthesia · 2025Article
- How to recognize a trustworthy clinical practice guideline.Journal of anesthesia, analgesia and critical care · 2023Review
- Airway and Respiratory Devices in the Prevention of Ventilator-Associated Pneumonia.Medicina (Kaunas, Lithuania) · 2023Review
- Blended learning program for the development of skills in the aspiration of artificial airways.Revista latino-americana de enfermagem · 2021Article
- Risk factors associated with symptoms of post-extubation upper airway obstruction in the emergency setting.The Journal of international medical research · 2020Observational
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Authors and funding
13 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundContinuous aspiration of subglottic secretions is effective in preventing ventilator-associated pneumonia, but it involves a risk of mucosal damage. The main objective of our study was to determine the incidence of airway complications related to continuous aspiration of subglottic secretions.
methodsIn consecutive adult patients with continuous aspiration of subglottic secretions, we prospectively recorded clinical airway complications during the period after extubation. A multidetector computed tomography of the neck was performed during the period of 5 days following extubation to classify subglottic and tracheal lesions as mucosal thickening, cartilage thickening or deep ulceration.
resultsIn the 86 patients included in the study, 6 (6.9%) had transient dyspnea, 7 (8.1%) had upper airway obstruction and 18 (20.9%) had dysphonia at extubation. Univariate analysis identified more attempts required for intubation (2.3 ± 1.1 vs. 1.2 ± 0.5; p = 0.001), difficult intubation (71.4 vs. 10.1%, p = 0.001) and Cormack score III-IV (71.4 vs. 8.8%; p < 0.001) as risk factors for having an upper airway obstruction at extubation. The incidence of failed extubation among patients after planned extubation was 18.9% and 11 patients (12.7%) required tracheostomy. A multidetector computed tomography was performed in 37 patients following extubation, and injuries were observed in 9 patients (24.3%) and classified as tracheal injuries in 2 patients (1 cartilage thickening and 1 mild stenosis with cartilage thickening) and as subglottic mucosal thickenings in 7 patients.
conclusionsThe incidence of upper airway obstruction after extubation in patients with continuous aspiration of subglottic secretions was 8.1%, and the injuries observed by computed tomography were not severe and located mostly in subglottic space.
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