Laryngeal sequelae following prolonged intubation: A prospective study

Background: Laryngeal injuries following intubation have a reported incidence from 63 to 94% and permanent sequelae are reported to be about 10 to 22% in the world literature. While several studies assessing the laryngeal complications are available in Caucasoid populations, minimal data is available in the literature regarding south Indian population.
Aim: The aim of this study was to evaluate laryngeal lesions in patients after prolonged intubation (>24 h), to correlate these lesions with the variables involved in the process of intubation and to determine the risk factors.
Materials and Methods: This is a prospective study for 1 year of patients who were intubated for more than 24 h in our critical care unit. Patients underwent laryngeal video endoscopy on the day of extubation and after 3 weeks by an ENT surgeon who was blinded to the intubation variables.
Result: About 51 patients were included in the study. Laryngeal abnormalities were seen in 41 patients on the day of extubation. At the end of third week after extubation, only 10 patients had abnormal laryngeal findings. A multivariate stepwise regression model showed that bigger tube size ( P =0.02), longer duration of intubation ( P =0.01) and emergency intubation ( P = 0.02) was associated with higher incidence of laryngeal complications on the day of extubation. At the end of third week laryngeal findings were influenced only by the duration of intubation ( P =0.001).
Conclusion: Laryngeal sequelae after extubation is directly associated with duration of intubation.