Late Adverse Effects/Complications (Manifest Within Weeks-Months After Intubation)
Laryngotracheal Stenosis (see Tracheal Stenosis)
Epidemiology
- Generally Occurs Weeks-Months After Intubation
- Incidence: 1-21% (Ann Otol Rhinol Laryngol, 2007) [MEDLINE]
- Risk Factors (Ann Otol Rhinol Laryngol, 2007) [MEDLINE]
- Prior Irradiation for Oropharyngeal/Laryngeal Tumor
- Prior Non-Airway Surgery
- Prolonged Intubation >7 Days
- Laryngotracheal Stenosis Rarely Occurs in Patients Intubated for <3 Days
Physiology
- Laryngeal (Glottic) Stenosis: due to pressure from the endotracheal tube itself with local ischemia, inflammation, tissue necrosis, and scarring
- Usual Location is the Posterior Glottis and Interarytenoid Regions (Where the Endotracheal Tube Exerts the Most Pressure)
- Tracheal Stenosis
- Due to High Endotracheal Tube Cuff Pressure (at 20 cm H20, Cuff Pressure Will Exceed the Mean Capillary Pressure in the Mucosa), with Obstruction of Capillary Blood Flow and Associated Ischemia, Inflammation, Mucosal Erosion, Tissue Necrosis, Distorted Tracheal Architecture, and Scarring
- Usual Location/Appearance of Endotracheal Intubation-Associated Tracheal Stenosis is a Web-Like Stenosis at the Endotracheal Tube Cuff Site
- In Contrast, Tracheostomy-Associated Tracheal Stenosis Associated Typically Occurs Around the Tracheal Stoma (see Tracheostomy)
Diagnosis
- Bronchoscopy (see Bronchoscopy)
- Fiberoptic Laryngoscopy (see Fiberoptic Laryngoscopy)
- Pulmonary Function Tests (PFT’s) (see Pulmonary Function Tests)
- Fixed Upper Airway Obstruction Pattern
- Spiral Computed Tomography (CT) with Virtual Bronchoscopy (see Chest Computed Tomography)
- May Be Diagnostic (Eur Arch Otorhinolaryngol, 2009) [MEDLINE]
Clinical
- Failure to Wean from Mechanical Ventilation (in Patients on Mechanical Ventilation)
- Subacute/Progressive Dyspnea (see Dyspnea)
- Usually Becomes Symptomatic Approximately 5 Weeks to Months After Extubation
Treatment
- Rigid Bronchoscopy with Dilation/Laser Resection/Stenting (see Bronchoscopy)
- May Be Required for Tracheal Stenosis
- Mitomycin C (see Mitomycin)
- Has Been Used to Prevent Tracheal Restenosis After Local Procedures
- Surgical Resection
- May Be Required for Refractory Cases of Tracheal Stenosis
Laryngotracheomalacia (see Tracheobronchomalacia)
Epidemiology
- Well-Known Complication of Prolonged Endotracheal Intubation (Aust N Z J Surg, 1976) [MEDLINE]
- Generally Occurs Weeks-Months After Endotracheal Intubation
Mechanism
- Thinning and/or Destruction of Tracheal Cartilage Due to Increased Endotracheal Tube Cuff Pressure
Tracheoarterial Fistula (see Tracheoinnominate Artery Fistula)
Epidemiology
- Although Tracheoarterial Fistula is More Commonly Observed with Tracheostomy, Cases Have Been Reported with Prolonged Endotracheal Intubation (see Tracheostomy)
Mechanism
- Erosion Through Tracheal Wall into Innominate Artery
Clinical
- Tracheoinnominate Artery Fistula: usually
Tracheoesophageal Fistula (see Tracheoesophageal Fistula)
Epidemiology
- While Tracheoesophageal FistulaRarely Occurs with Endotracheal Intubation, Reported Cases Have Been Observed in Patients with Prolonged Intubation (Aust N Z J Surg, 1976) [MEDLINE]
- Risk Factors (Chest Surg Clin N Am, 1996) [MEDLINE]
- Corticosteroids (see Corticosteroids)
- Possible Risk Factor
- Diabetes Mellitus (see Diabetes Mellitus)
- Possible Risk Factor
- Excessive Mobility of the Endotracheal Tube
- High Airway Pressure
- High Endotracheal Tube Cuff Pressure
- Main Risk Factor
- Prolonged Duration of Mechanical Ventilation
- Use of Nasogastric Tube (see Nasogastric-Orogastric Tube)
- Possible Risk Factor
- Corticosteroids (see Corticosteroids)
- Risk Factors (Chest Surg Clin N Am, 1996) [MEDLINE]
Mechanism
- Erosion of the Endotracheal Tube Tip/Cuff into the Posterior Wall of the Trachea, Fistulizing into the Esophagus
Clinical
- Air Leak from Ventilator Circuit (“Lost Volume”)
- Gastric Distention (see Gastric Distention)
- Presence of Tube Feedings in Tracheal Secretions
- Recurrent Aspiration Pneumonia (see Aspiration Pneumonia)
References
Acalculous Cholecystitis (see Acalculous Cholecystitis)
- GI complications in patients receiving mechanical ventilation. Chest. 2001 Apr;119(4):1222-41. doi: 10.1378/chest.119.4.1222 [MEDLINE]
Acute Kidney Injury (AKI) (see Acute Kidney Injury)
- BEST Kidney Trial. Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA. 2005;294(7):813 [MEDLINE]
- Mechanical ventilation and acute renal failure. Crit Care Med. 2005;33(6):1408 [MEDLINE]
Arrhythmia/Cardiac Arrest (see Cardiac Arrest)
- Emergency tracheal intubation: complications associated with repeated laryngoscopic attempts. Anesth Analg. 2004 Aug;99(2):607-13, table of contents [MEDLINE]
- Factors associated with the occurrence of cardiac arrest after emergency tracheal intubation in the emergency department. PLoS One. 2014 Nov 17;9(11):e112779. doi: 10.1371/journal.pone.0112779. eCollection 2014 [MEDLINE]
- Cardiac Arrest and Mortality Related to Intubation Procedure in Critically Ill Adult Patients: A Multicenter Cohort Study. Crit Care Med. 2018 Apr;46(4):532-539. doi: 10.1097/CCM.0000000000002925 [MEDLINE]
- Shock Index as a Predictor of Post-Intubation Hypotension and Cardiac Arrest; A Review of the Current Evidence. Bull Emerg Trauma. 2019 Jan;7(1):21-27. doi: 10.29252/beat-070103 [MEDLINE]
Arytenoid Cartilage Dislocation
- Cardiovascular operation: A significant risk factor of arytenoid cartilage dislocation/subluxation after anesthesia. Ann Card Anaesth. 2017 Jul-Sep;20(3):309-312. doi: 10.4103/aca.ACA7117 [MEDLINE]
- Arytenoid cartilage dislocation mimicking bilateral vocal cord paralysis: A case report. Medicine (Baltimore). 2017 Nov;96(45):e8514. doi: 10.1097/MD.0000000000008514 [MEDLINE]
- Unusual cause of hoarseness: Arytenoid cartilage dislocation without a traumatic event. Am J Emerg Med. 2018 Jan;36(1):172.e1-172.e2. doi: 10.1016/j.ajem.2017.10.041 [MEDLINE]
- BMI May Be the Risk Factor for Arytenoid Dislocation Caused by Endotracheal Intubation: A Retrospective Case-Control Study. J Voice. 2018 Mar;32(2):221-225. doi: 10.1016/j.jvoice.2017.05.010 [MEDLINE]
Aspiration Pneumonia (see Aspiration Pneumonia)
- Swallowing disorders in patients with prolonged orotracheal intubation or tracheostomy tubes. Crit Care Med. 1990 Dec;18(12):1328-30. doi: 10.1097/00003246-199012000-00004 [MEDLINE]
- Effect of positive expiratory pressure and type of tracheal cuff on the incidence of aspiration in mechanically ventilated patients in an intensive care unit. Crit Care Med. 2008;36(2):409 [MEDLINE]
- CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008;36(5):309 [MEDLINE]
Auto-Positive End-Expiratory Pressure (Auto-PEEP or Intrinsic PEEP) (see Invasive Mechanical Ventilation-General)
- Occult positive end-expiratory pressure in mechanically ventilated patients with airflow obstruction: the auto-PEEP effect. Am Rev Respir Dis. 1982;126(1):166 [MEDLINE]
- PEEP, auto-PEEP, and waterfalls. Chest. 1989 Sep;96(3):449-51 [MEDLINE]
- Detection of expiratory flow limitation during mechanical ventilation. Am J Respir Crit Care Med. 1994;150(5 Pt 1):1311 [MEDLINE]
- Expiratory muscle activity increases intrinsic positive end-expiratory pressure independently of dynamic hyperinflation in mechanically ventilated patients. Am J Respir Crit Care Med. 1995;151(2 Pt 1):562 [MEDLINE]
- Mean airway pressure as an index of mean alveolar pressure. Am J Respir Crit Care Med. 1996;153(6 Pt 1):1825 [MEDLINE]
- Clinical examination reliably detects intrinsic positive end-expiratory pressure in critically ill, mechanically ventilated patients. Am J Respir Crit Care Med. 1999;159(1):290 [MEDLINE]
- Intrinsic positive end-expiratory pressure in mechanically ventilated patients with and without tidal expiratory flow limitation. Crit Care Med. 2000;28(12):3837 [MEDLINE]
- Dynamic hyperinflation and auto-positive end-expiratory pressure: lessons learned over 30 years. Am J Respir Crit Care Med. 2011;184:756–762 [MEDLINE]
Bronchospasm (see Bronchospasm)
- [A survey of perioperative bronchospasm in 105 patients with reactive airway disease]. Masui. 1995;44(3):396 [MEDLINE]
Constipation (see Constipation)
- GI complications in patients receiving mechanical ventilation. Chest. 2001 Apr;119(4):1222-41. doi: 10.1378/chest.119.4.1222 [MEDLINE]
Decubitus Ulcer (see Decubitus Ulcer)
- Effects of elevating the head of bed on interface pressure in volunteers. Crit Care Med. 2008;36(11):3038 ([MEDLINE]
Deep Venous Thrombosis (DVT) (see Deep Venous Thrombosis)
- Association between aspirin use and deep venous thrombosis in mechanically ventilated ICU patients. J Thromb Thrombolysis. 2017 Oct;44(3):330-334. doi: 10.1007/s11239-017-1525-x [MEDLINE]
Dental/Lingual/Orolabial/Pharyngeal/Laryngeal Mucosal Injury
- Anesthesia-induced dental injury. Int Anesthesiol Clin. 1989;27(2):120 [MEDLINE]
Diarrhea (see Diarrhea)
- GI complications in patients receiving mechanical ventilation. Chest. 2001 Apr;119(4):1222-41. doi: 10.1378/chest.119.4.1222 [MEDLINE]
Endotracheal Tube Cuff/Ventilator Circuit Leak
- Massive airway leaks: an analysis of the role of endotracheal tubes. Crit Care Med. 1993 Apr;21(4):518-21 [MEDLINE]
- Endotracheal tube cuff leaks: causes, consequences, and management. Anesth Analg. 2013 Aug;117(2):428-34 [MEDLINE]
- Efficacy of using an intravenous catheter to repair damaged expansion lines of endotracheal tubes and laryngeal masks. BMC Anesthesiol. 2022 Jul 26;22(1):238. doi: 10.1186/s12871-022-01776-5 [MEDLINE]
Endotracheal Tube Tip Malpositioning
- Massive airway leaks: an analysis of the role of endotracheal tubes. Crit Care Med. 1993 Apr;21(4):518-21 [MEDLINE]
Erosive Esophagitis (see Esophagitis)
- GI complications in patients receiving mechanical ventilation. Chest. 2001 Apr;119(4):1222-41. doi: 10.1378/chest.119.4.1222 [MEDLINE]
Esophageal Injury
- Mediastinitis and sepsis syndrome following intubation. Anaesthesia. 1994 Oct;49(10):883-5. doi: 10.1111/j.1365-2044.1994.tb04266.x [MEDLINE]
Gastrointestinal Stress Ulceration (see Peptic Ulcer Disease)
- The effects of positive end-expiratory pressure on the splanchnic circulation. Intensive Care Med. 2000 Apr;26(4):361-3. doi: 10.1007/s001340051168 [MEDLINE]
- GI complications in patients receiving mechanical ventilation. Chest. 2001 Apr;119(4):1222-41. doi: 10.1378/chest.119.4.1222 [MEDLINE]
Ileus (and Gastrointestinal Hypomotility) (see Ileus)
- Gastroduodenal motility in mechanically ventilated critically ill patients: a manometric study. Crit Care Med. 1994 Mar;22(3):441-7. doi: 10.1097/00003246-199403000-00014 [MEDLINE]
- GI complications in patients receiving mechanical ventilation. Chest. 2001 Apr;119(4):1222-41. doi: 10.1378/chest.119.4.1222 [MEDLINE]
Gastrointestinal Ulceration (see Peptic Ulcer Disease)
- Gastroduodenal motility in mechanically ventilated critically ill patients: a manometric study. Crit Care Med. 1994;22(3):441 [MEDLINE]
- The effects of positive end-expiratory pressure on the splanchnic circulation. Intensive Care Med. 2000;26(4):361 [MEDLINE]
- Effect of positive end-expiratory pressure on splanchnic perfusion in acute lung injury. Intensive Care Med. 2000;26(4):376 [MEDLINE]
- GI complications in patients receiving mechanical ventilation. Chest. 2001;119(4):1222 [MEDLINE]
Impaired Mucociliary Motility
- Mucociliary transport in ICU patients. Chest. 1994;105(1):237 [MEDLINE]
- Effect of On-Demand vs Routine Nebulization of Acetylcysteine With Salbutamol on Ventilator-Free Days in Intensive Care Unit Patients Receiving Invasive Ventilation: A Randomized Clinical Trial. JAMA. 2018;319(10):993 [MEDLINE]
Increased Intracranial Pressure (see Increased Intracranial Pressure)
- Mechanical ventilation triggers hippocampal apoptosis by vagal and dopaminergic pathways. Am J Respir Crit Care Med. 2013 Sep;188(6):693-702 [MEDLINE]
Induction of Inflammatory Response
- Effect of mechanical ventilation on inflammatory mediators in patients with acute respiratory distress syndrome: a randomized controlled trial. JAMA. 1999;282(1):54 [MEDLINE]
Insulin Resistance
- Physical inactivity rapidly induces insulin resistance and microvascular dysfunction in healthy volunteers. Arterioscler Thromb Vasc Biol. 2007;27(12):2650 [MEDLINE]
Intensive Care Unit (ICU)-Acquired Weakness (see Intensive Care Unit-Acquired Weakness)
- ICU-acquired weakness. Chest. 2007;131(5):1541 [MEDLINE]
- Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009;373(9678):1874 [MEDLINE]
Joint Contracture
- Joint contracture following prolonged stay in the intensive care unit. CMAJ. 2008;178(6):691 [MEDLINE]
Laryngeal Injury
- Intubation lesions of the larynx. Br J Anaesth. 1978;50(6):587 [MEDLINE]
- Postoperative sore throat: influence of tracheal tube lubrication versus cuff design. Can Anaesth Soc J. 1980;27(2):156 [MEDLINE]
- Laryngeal injuries secondary to nasogastric tubes. Ann Otol Rhinol Laryngol. 1981;90(5 Pt 1):469 [MEDLINE]
- The influence of endotracheal tube cuff design and cuff lubrication on postoperative sore throat. Anesthesiology. 1983;58(4):376 [MEDLINE]
- Laryngotracheal injury due to endotracheal intubation: incidence, evolution, and predisposing factors. A prospective long-term study. Crit Care Med. 1983;11(5):362 [MEDLINE]
- True vocal cord paralysis following intubation. Laryngoscope. 1985;95(11):1352 [MEDLINE]
- Correlation of endotracheal tube size with sore throat and hoarseness following general anesthesia. Anesthesiology. 1987 Sep;67(3):419-21 [MEDLINE]
- Laryngeal complications of prolonged intubation. Chest. 1989;96(4):877 [MEDLINE]
- Evaluation of risk factors for laryngeal edema after tracheal extubation in adults and its prevention by dexamethasone. A placebo-controlled, double-blind, multicenter study. Anesthesiology. 1992;77(2):245 [MEDLINE]
- Adverse respiratory events infrequently leading to malpractice suits. A closed claims analysis. Anesthesiology. 1991;75(6):932 [MEDLINE]
- Evaluation of risk factors for laryngeal edema after tracheal extubation in adults and its prevention by dexamethasone: a placebo-controlled, double-blind, multicenter study. Anesthesiology 1992;77:245–251 [MEDLINE]
- Surgical considerations in tracheal stenosis. Laryngoscope. 1992 Mar;102(3):237-43 [MEDLINE]
- Resolution of laryngeal injury following translaryngeal intubation. Am Rev Respir Dis. 1992;145(2 Pt 1):361 [MEDLINE]
- Airway considerations in the management of patients requiring long-term endotracheal intubation. Anesth Analg. 1992;74(2):276 [MEDLINE]
- Massive airway leaks: an analysis of the role of endotracheal tubes. Crit Care Med. 1993;21(4):518 [MEDLINE]
- Risk factors associated with prolonged intubation and laryngeal injury. Otolaryngol Head Neck Surg. 1994 Oct;111(4):453-9 [MEDLINE]
- Mediastinitis and sepsis syndrome following intubation. Anaesthesia. 1994;49(10):883 [MEDLINE]
- Association between reduced cuff leak volume and postextubation stridor. Chest. 1996;110(4):1035 [MEDLINE]
- Gastroesophageal reflux in patients with subglottic stenosis. Arch Otolaryngol Head Neck Surg. 1998 May;124(5):551-5 [MEDLINE]
- Airway injury during anesthesia: a closed claims analysis. Anesthesiology. 1999;91(6):170 [MEDLINE]
- The cuff leak test to predict failure of tracheal extubation for laryngeal edema. Intensive Care Med. 2002;28(9):1267 [MEDLINE]
- Post-extubation stridor in intensive care unit patients. Risk factors evaluation and importance of the cuff-leak test. Intensive Care Med. 2003;29(1):69 [MEDLINE]
- How to identify patients with no risk for postextubation stridor? J Crit Care. 2004;19(1):23 [MEDLINE]
- Vocal fold injury following endotracheal intubation. J Laryngol Otol. 2005 Oct;119(10):825-7 [MEDLINE]
- The endotracheal tube cuff-leak test as a predictor for postextubation stridor. Respir Care. 2005;50(12):1632 [MEDLINE]
- Association of airway abnormalities and risk factors in 37 subglottic stenosis patients. Otolaryngol Head Neck Surg. 2006 Sep;135(3):434-7 [MEDLINE]
- Intravenous injection of methylprednisolone reduces the incidence of postextubation stridor in intensive care unit patients. Crit Care Med. 2006;34(5):1345 [MEDLINE]
- Laryngeal ultrasound: a useful method in predicting post-extubation stridor. A pilot study. Eur Respir J. 2006;27(2):384 [MEDLINE]
- Dexamethasone to prevent postextubation airway obstruction in adults: a prospective, randomized, double-blind, placebo-controlled study. Crit Care. 2007;11(4):R72 [MEDLINE]
- 12-h pretreatment with methylprednisolone versus placebo for prevention of postextubation laryngeal oedema: a randomised double-blind trial. Lancet. 2007;369(9567):1083 [MEDLINE]
- Age and comorbidity as risk factors for vocal cord paralysis associated with tracheal intubation. Br J Anaesth. 2007 Apr;98(4):524-30. Epub 2007 Mar 6 [MEDLINE]
- Short-term effects of endotracheal intubation on voice. J Voice. 2007 Nov;21(6):762-8. Epub 2006 Aug 14 [MEDLINE]
- Continuous airway access for the difficult extubation: the efficacy of the airway exchange catheter. Anesth Analg. 2007;105(5):1357 [MEDLINE]
- Age and comorbidity as risk factors for vocal cord paralysis associated with tracheal intubation. Br J Anaesth. 2007 Apr;98(4):524-30 [MEDLINE]
- Risk factors evaluation and the cuff leak test as predictors for postextubation stridor. J Med Assoc Thai. 2008;91(5):648 [MEDLINE]
- Prophylactic administration of parenteral steroids for preventing airway complications after extubation in adults: meta-analysis of randomised placebo controlled trials. BMJ. 2008;337:a1841 [MEDLINE]
- Cuff-leak test for the diagnosis of upper airway obstruction in adults: a systematic review and meta-analysis. Intensive Care Med. 2009;35(7):1171 [MEDLINE]
- Corticosteroids for the prevention and treatment of post-extubation stridor in neonates, children and adults. Cochrane Database Syst Rev. 2009 [MEDLINE]
- Post-intubation laryngeal injuries and extubation failure: a fiberoptic endoscopic study. Intensive Care Med. 2010 Jun;36(6):991-8. doi: 10.1007/s00134-010-1847-z [MEDLINE]
- Cost analysis of intubation-related tracheal injury using a national database. Otolaryngol Head Neck Surg. 2010 Jul;143(1):31-6. doi: 10.1016/j.otohns.2009.11.004 [MEDLINE]
- Laryngeal injury from prolonged intubation: a prospective analysis of contributing factors. Laryngoscope. 2011 Mar;121(3):596-600. doi: 10.1002/lary.21403 [MEDLINE]
- Cuff-leak test for predicting postextubation airway complications: a systematic review. J Evid Based Med 2011;4:242–254 [MEDLINE]
- Methylprednisolone reduces the rates of postextubation stridor and reintubation associated with attenuated cytokine responses in critically ill patients. Minerva Anestesiol. 2011 May;77(5):503-9 [MEDLINE]
- Laryngeal injury from prolonged intubation: a prospective analysis of contributing factors. Laryngoscope. 2011;121(3):596. Epub 2010 Dec 16 [MEDLINE]
- Laryngeal injury from prolonged intubation: a prospective analysis of contributing factors. Laryngoscope. 2011;121(3):596 [MEDLINE]
- Postextubation obstructive pseudomembranes: a case series and review of a rare complication after endotracheal intubation. Lung. 2011 Feb;189(1):81-6 [MEDLINE]
- Association between repeated intubation attempts and adverse events in emergency departments: an analysis of a multicenter prospective observational study. Ann Emerg Med. 2012 Dec;60(6):749-754.e2 [MEDLINE]
- The effect of body mass index on intubation success rates and complications during emergency airway management. Intern Emerg Med. 2013 Feb;8(1):75-82. doi: 10.1007/s11739-012-0874-x [MEDLINE]
- Predicting laryngeal edema in intubated patients by portable intensive care unit ultrasound. J Crit Care. 2013 Oct;28(5):675-80. Epub 2013 Jun 24 [MEDLINE]
- Cuff Leak Test for the Diagnosis of Post-Extubation Stridor. J Intensive Care Med. 2017 Jan 1:885066617700095. doi: 10.1177/0885066617700095 [MEDLINE]
- An Official American Thoracic Society/American College of Chest Physicians Clinical Practice Guideline: Liberation from Mechanical Ventilation in Critically Ill Adults. Rehabilitation Protocols, Ventilator Liberation Protocols, and Cuff Leak Tests. Am J Respir Crit Care Med. 2017;195(1):120 [MEDLINE]
Laryngotracheal Stenosis (see Tracheal Stenosis)
- Association of airway abnormalities and risk factors in 37 subglottic stenosis patients. Otolaryngol Head Neck Surg. 2006 Sep;135(3):434-7 [MEDLINE]
- Risk factors for adult laryngotracheal stenosis: a review of 74 cases. Ann Otol Rhinol Laryngol. 2007 Mar;116(3):206-10 [MEDLINE]
- Spiral CT virtual bronchoscopy with multiplanar reformatting in the evaluation of post-intubation tracheal stenosis: comparison between endoscopic, radiological and surgical findings. Eur Arch Otorhinolaryngol. 2009;266(6):863 [MEDLINE]
Laryngotracheomalacia (see Tracheobronchomalacia)
- Tracheal injury following prolonged intubation. Aust N Z J Surg. 1976 Feb;46(1):18-25. doi: 10.1111/j.1445-2197.1976.tb03186.x [MEDLINE]
Neurologic Complications
- Unsuspected cervical fractures: a common problem in ankylosing spondylitis. Anesthesiology. 1989;70(5):869 [MEDLINE]
- Mechanical ventilation triggers hippocampal apoptosis by vagal and dopaminergic pathways. Am J Respir Crit Care Med. 2013 Sep 15;188(6):693-702. doi: 10.1164/rccm.201304-0691OC [MEDLINE]
Oxygen Toxicity (see Oxygen)
- Protective effect of hypoxia on bleomycin lung toxicity in the rat. Am Rev Respir Dis. 1984 Aug;130(2):307-8. doi: 10.1164/arrd.1984.130.2.307 [MEDLINE]
- Supplementary oxygen in healthy subjects and those with COPD increases oxidative stress and airway inflammation. Thorax. 2004 Dec;59(12):1016-9. doi: 10.1136/thx.2003.020768 [MEDLINE]
Patient-Ventilator Dyssynchrony
- Effect of inspiratory flow rate on respiratory sensation and pattern of breathing. Am J Respir Crit Care Med. 1995;151(3 Pt 1):751 [MEDLINE]
- Inspiratory gas flow induced by cardiac systole. Respir Physiol. 1996;105(1-2):103-108 [MEDLINE]
- Dyspnea in the ventilated patient: a call for patient-centered mechanical ventilation. Respir Care. 2000;45(12):1460 [MEDLINE]
- Patient-ventilator interaction. Am J Respir Crit Care Med. 2001;163(5):1059 [MEDLINE]
- Patient-ventilator interaction. Br J Anaesth. 2003 Jul;91(1):106-19 [MEDLINE]
- Using ventilator graphics to identify patient-ventilator asynchrony. Respir Care. 2005;50(2):202 [MEDLINE]
- Applied respiratory physiology: use of ventilator waveforms and mechanics in the management of critically ill patients. Respir Care. 2005;50(2):287–293 [MEDLINE]
- Patient-ventilator asynchrony during assisted mechanical ventilation. Intensive Care Med. 2006 Oct;32(10):1515-22. Epub 2006 Aug 1 [MEDLINE]
- Bedside waveforms interpretation as a tool to identify patient-ventilator asynchronies. Intensive Care Med. 2006;32(1):3 [MEDLINE]
- Patient-ventilator asynchrony during assisted mechanical ventilation. Intensive Care Med. 2006;32(10):1515 [MEDLINE]
- Reduction of patient-ventilator asynchrony by reducing tidal volume during pressure-support ventilation. Intensive Care Med. 2008 Aug;34(8):1477-86. doi: 10.1007/s00134-008-1121-9. Epub 2008 Apr 24 [MEDLINE]
- Excessive tidal volume from breath stacking during lung-protective ventilation for acute lung injury. Crit Care Med. 2008;36(11):3019 [MEDLINE]
- Observational study of patient-ventilator asynchrony and relationship to sedation level. J Crit Care. 2009;24(1):74 [MEDLINE]
- Ineffective triggering predicts increased duration of mechanical ventilation. Crit Care Med. 2009;37(10):2740 [MEDLINE]
- Monitoring of patient-ventilator interaction at the bedside. Respir Care. 2011 Jan;56(1):61-72. doi: 10.4187/respcare.01077 [MEDLINE]
- Ineffective efforts during mechanical ventilation: the brain wants, the machine declines. Intensive Care Med. 2012;38(5):738 [MEDLINE]
- Mechanical ventilation-induced reverse-triggered breaths: a frequently unrecognized form of neuromechanical coupling. Chest. 2013 Apr;143(4):927-938. doi: 10.1378/chest.12-1817 [MEDLINE]
- Patient-ventilator interactions. Implications for clinical management. Am J Respir Crit Care Med. 2013 Nov 1;188(9):1058-68. doi: 10.1164/rccm.201212-2214CI [MEDLINE]
- Patient ventilator asynchrony in critically ill adults: frequency and types. Heart Lung. 2014 May-Jun;43(3):231-43. doi: 10.1016/j.hrtlng.2014.02.002 [MEDLINE]
- Asynchronies during mechanical ventilation are associated with mortality. Intensive Care Med. 2015;41(4): 633–641; published online Feb 2015 [MEDLINE]
- Does This Ventilated Patient Have Asynchronies? Recognizing Reverse Triggering and Entrainment at the Bedside. Intensive Care Med. 2016 Jun;42(6):1058-61. doi: 10.1007/s00134-015-4177-3 [MEDLINE]
- Patient-ventilator asynchrony. Curr Opin Crit Care. 2016 Feb;22(1):53-9. doi: 10.1097/MCC.0000000000000270 [MEDLINE]
- Patient-Ventilator Asynchrony Due to Reverse Triggering Occurring in Brain-Dead Patients: Clinical Implications and Physiological Meaning. Am J Respir Crit Care Med. 2016 Nov 1;194(9):1166-1168. doi: 10.1164/rccm.201603-0483LE [MEDLINE]
- Reverse Triggering Causes an Injurious Inflation Pattern During Mechanical Ventilation. Am J Respir Crit Care Med. 2018 Oct 15;198(8):1096-1099. doi: 10.1164/rccm.201804-0649LE [MEDLINE]
- Reverse Triggering Induced by Endotracheal Tube Leak in Lightly Sedated ARDS Patient. J Intensive Care 2018 Jul 28;6:41. doi: 10.1186/s40560-018-0314-8. eCollection 2018 [MEDLINE]
- Minimizing Asynchronies in Mechanical Ventilation: Current and Future Trends. Respir Care. 2018 Apr;63(4):464-478. doi: 10.4187/respcare.05949 [MEDLINE]
- Asynchrony Consequences and Management. Crit Care Clin. 2018 Jul;34(3):325-341. doi: 10.1016/j.ccc.2018.03.008 [MEDLINE]
- Effect of cardiogenic oscillations on trigger delay during pressure support ventilation. Respir Care. 2018;63(7):865-872 [MEDLINE]
- Variability of reverse triggering in deeply sedated ARDS patients. Intensive Care Med. 2019 May;45(5):725-726. doi: 10.1007/s00134-018-5500-6 [MEDLINE]
- Patient-ventilator Asynchronies During Mechanical Ventilation: Current Knowledge and Research Priorities. Intensive Care Med Exp. 2019 Jul 25;7(Suppl 1):43. doi: 10.1186/s40635-019-0234-5 [MEDLINE]
- Cardiogenic Auto-Triggering as a Consequence of Hemoperitoneum. Chest 2020 Jul;158(1):e1-e3. doi: 10.1016/j.chest.2020.03.023 [MEDLINE]
Pharyngitis (see Pharyngitis)
- Prophylactic laryngo-tracheal aerosolized lidocaine against postoperative sore throat. Acta Anaesthesiol Scand. 1992;36(6):505 [MEDLINE]
- Postoperative sore throat after ambulatory surgery. Br J Anaesth. 2002;88(4):582 [MEDLINE]
- Incidence and risk factors of postoperative sore throat after endotracheal intubation in Korean patients. J Int Med Res. 2017;45(2):744 [MEDLINE]
- Effect of Endotracheal Tube Cuff Shape on Postoperative Sore Throat After Endotracheal Intubation. Anesth Analg. 2017;125(4):1240 [MEDLINE]
- The Effect of Zinc Lozenge on Postoperative Sore Throat: A Prospective Randomized, Double-Blinded, Placebo-Controlled Study. Anesth Analg. 2018;126(1):78 [MEDLINE]
- Postoperative patient complaints: a prospective interview study of 12,276 patients. J Clin Anesth. 2010;22(1):13 [MEDLINE]
- Endotracheal tube size and sore throat following surgery: a randomized-controlled study. Acta Anaesthesiol Scand. 2010 Feb;54(2):147-53 [MEDLINE]
Positive Pressure-Induced Artifacts Introduced into the Measurement of Hemodynamic Pressures
- Estimation of transmural cardiac pressures during ventilation with PEEP. J Appl Physiol Respir Environ Exerc Physiol. 1982;53(2):384 [MEDLINE]
- Estimating cardiac filling pressure in mechanically ventilated patients with hyperinflation. Crit Care Med. 2000;28(11):3631 [MEDLINE]
Post-Intubation Hypoxemia (see Hypoxemia)
- Endotracheal intubation in the ICU. Crit Care. 2015 Jun 17;19(1):258. doi: 10.1186/s13054-015-0964-z [MEDLINE]
Post-Intubation Hypotension (see Hypotension)
- Hemodynamic responses to mechanical ventilation with PEEP: the effect of hypervolemia. Anesthesiology. 1975;42(1):45 [MEDLINE]
- Hemodynamic impact of a positive end-expiratory pressure setting in acute respiratory distress syndrome: importance of the volume status. Crit Care Med. 2010;38(3):802 [MEDLINE]
- Incidence of and risk factors for severe cardiovascular collapse after endotracheal intubation in the ICU: a multicenter observational study. Crit Care. 2015 Jun 18;19:257. doi: 10.1186/s13054-015-0975-9 [MEDLINE]
- Association of fentanyl use in rapid sequence intubation with post-intubation hypotension. Am J Emerg Med. 2018 Nov;36(11):2044-2049. doi: 10.1016/j.ajem.2018.03.026 [MEDLINE]
- Association of ketamine use with lower risks of post-intubation hypotension in hemodynamically-unstable patients in the emergency department. Sci Rep. 2019 Nov 21;9(1):17230. doi: 10.1038/s41598-019-53360-6 [MEDLINE]
- The incidence of post-intubation hypertension and association with repeated intubation attempts in the emergency department. PLoS One. 2019 Feb 11;14(2):e0212170. doi: 10.1371/journal.pone.0212170. eCollection 2019 [MEDLINE]
- Shock Index as a Predictor of Post-Intubation Hypotension and Cardiac Arrest; A Review of the Current Evidence. Bull Emerg Trauma. 2019 Jan;7(1):21-27. doi: 10.29252/beat-070103 [MEDLINE]
- Effect of Fluid Bolus Administration on Cardiovascular Collapse Among Critically Ill Patients Undergoing Tracheal Intubation: A Randomized Clinical Trial. JAMA. 2022 Jun 16. doi: 10.1001/jama.2022.9792 [MEDLINE]
Sleep Disruption
- Sleep in critically ill patients requiring mechanical ventilation. Chest. 2000;117(3):809 [MEDLINE]
- Effect of ventilator mode on sleep quality in critically ill patients. Am J Respir Crit Care Med. 2002;166(11):1423 [MEDLINE]
- Contribution of the intensive care unit environment to sleep disruption in mechanically ventilated patients and healthy subjects. Am J Respir Crit Care Med. 2003;167(5):708 [MEDLINE]
- Sleep quality in mechanically ventilated patients: comparison of three ventilatory modes. Crit Care Med. 2008;36(6):1749 [MEDLINE]
- A new classification for sleep analysis in critically ill patients. Sleep Med. 2012 Jan;13(1):7-1 [MEDLINE]
- Characterisation of sleep in intensive care using 24-hour polysomnography: an observational study. Crit Care. 2013;17(2):R46 [MEDLINE]
- Positive and negative effects of mechanical ventilation on sleep in the ICU: a review with clinical recommendations. Intensive Care Med. 2016 Apr;42(4):531-41 [MEDLINE]
- Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. Crit Care Med. 2018;46(9):e825 [MEDLINE]
Swallowing/Speech Impairment (see Dysphagia)
- Swallowing disorders in patients with prolonged orotracheal intubation or tracheostomy tubes. Crit Care Med. 1990;18(12):1328 [MEDLINE]
- Postextubation fiberoptic endoscopic evaluation of swallowing after prolonged endotracheal intubation: a randomized, prospective trial. Crit Care Med. 2001;29(9):1710 [MEDLINE]
- Short-term effects of endotracheal intubation on voice. J Voice. 2007 Nov;21(6):762-8 [MEDLINE]
- Incidence and impact of dysphagia in patients receiving prolonged endotracheal intubation after cardiac surgery. Can J Surg. 2009;52(2):119 [MEDLINE]
- The incidence of dysphagia following endotracheal intubation: a systematic review. Chest. 2010 Mar;137(3):665-73. doi: 10.1378/chest.09-1823 [MEDLINE]
Tracheoarterial Fistula (see Tracheoinnominate Artery Fistula)
- High mortality in patients with tracheoarterial fistulas: clinical experience and treatment recommendations. Interact Cardiovasc Thorac Surg. 2018 Jan 1;26(1):12-17. doi: 10.1093/icvts/ivx249 [MEDLINE]
Tracheoesophageal Fistula (see Tracheoesophageal Fistula)
- Ulcerative tracheo-oesophageal fistula during treatment by tracheostomy and intermittent positive pressure ventilation. Thorax. 1972;27(3):338 [MEDLINE]
- Tracheal injury following prolonged intubation. Aust N Z J Surg. 1976 Feb;46(1):18-25 [MEDLINE]
- Tracheoesophageal fistula formation in intubated patients. Risk factors and treatment with high-frequency jet ventilation. Chest. 1990;98(1):161 [MEDLINE]
- Management of acquired tracheoesophageal fistula. Chest Surg Clin N Am. 1996 Nov;6(4):819-36 [MEDLINE]
- Tracheoesophageal fistula. Chest Surg Clin N Am. 2003 May;13(2):271-89 [MEDLINE]
- Review of tracheo-esophageal fistula associated with endotracheal intubation. J Surg Educ. 2007 Jul-Aug;64(4):237-40 [MEDLINE]
- Posttracheostomy tracheoesophageal fistula. J Anaesthesiol Clin Pharmacol. 2012 Jan;28(1):140-1 [MEDLINE]
- Surgical Management of Benign Acquired Tracheoesophageal Fistulas: A Ten-Year Experience. Ann Thorac Surg. 2016;102(4):1081 [MEDLINE]
Translocation of Tracheal Bacteria into the Bloodstream
- Effect of mechanical ventilation strategy on dissemination of intratracheally instilled Escherichia coli in dogs. Crit Care Med. 1997;25(10):1733 [MEDLINE]
Ventilator-Induced Diaphragmatic Dysfunction (VIDD)
- Rapid disuse atrophy of diaphragm fibers in mechanically ventilated humans. N Engl J Med. 2008;358(13):1327 [MEDLINE]
- Rapidly progressive diaphragmatic weakness and injury during mechanical ventilation in humans. Am J Respir Crit Care Med. 2011;183(3):364 [MEDLINE]
- Diaphragm dysfunction assessed by ultrasonography: Influence on weaning from mechanical ventilation. Crit Care Med. 2011;39:2627–30 [MEDLINE]
- Mitochondrial dysfunction and lipid accumulation in the human diaphragm during mechanical ventilation. Am J Respir Crit Care Med. 2012 Dec;186(11):1140-9 [MEDLINE]
- Diaphragm dysfunction on admission to the intensive care unit; prevalence, risk factors, and prognostic impact-a prospective study. Am J Respir Crit Care Med. 2013;188:213–9 [MEDLINE]
- Diaphragm ultrasound as a predictor of successful extubation from mechanical ventilation. Thorax. 2014 May;69(5):423-7 [MEDLINE]
- Coexistence and impact of limb muscle and diaphragm weakness at time of liberation from mechanical ventilation in medical intensive care unit patients. Am J Respir Crit Care Med. 2016;195:57–66 [MEDLINE]
- Mechanical ventilation–induced diaphragm atrophy strongly impacts clinical outcomes. Am J Respir Crit Care Med. 2018 Jan 15;197(2):204-213. doi: 10.1164/rccm.201703-0536OC. [MEDLINE]
- Severe but reversible impaired diaphragm function in septic mechanically ventilated patients. Ann Intensive Care. 2022 Apr 11;12(1):34. doi: 10.1186/s13613-022-01005-9 [MEDLINE]
Ventilator-Induced Lung Injury (VILI)/Barotrauma
- Incidence of pulmonary barotrauma in a medical ICU. Crit Care Med. 1983;11(2):67 [MEDLINE]
- Persistent bronchopleural air leak during mechanical ventilation. A review of 39 cases. Chest. 1986;90(3):321 [MEDLINE]
- The effects of ventilatory pattern on hyperinflation, airway pressures, and circulation in mechanical ventilation of patients with severe air-flow obstruction. Am Rev Respir Dis. 1987 Oct;136(4):872-9 [MEDLINE]
- Closure of a bronchopleural fistula with bronchoscopic instillation of tetracycline. Chest. 1991;99(4):1040 [MEDLINE]
- Mean airway pressure: physiologic determinants and clinical importance–Part 2: Clinical implications. Crit Care Med. 1992;20(11):1604 [MEDLINE]
- Risk factors for morbidity in mechanically ventilated patients with acute severe asthma. Am Rev Respir Dis. 1992;146(3):60 [MEDLINE]
- Pulmonary barotrauma in mechanical ventilation: patterns and risk factors. Chest 1992; 102:568-572
- Barotrauma: detection, recognition, and management. Chest 1993; 104:578-584
- Continuous venous air embolism in patients receiving positive end-expiratory pressure. Am Rev Respir Dis. 1993;147(4):1034 [MEDLINE]
- Mechanisms of ventilator-induced lung injury. Crit Care Med. 1993;21(1):131 [MEDLINE]
- Lung structure and function in different stages of severe adult respiratory distress syndrome. JAMA. 1994;271(22):1772 [MEDLINE]
- Peak airway pressure: why the fuss? Chest. 1994;105(1):242 [MEDLINE]
- Frequency and importance of barotrauma in 100 patients with acute lung injury. Crit Care Med. 1995;23(2):272 [MEDLINE]
- Independent lung ventilation with a single ventilator using a variable resistance valve. Chest. 1995;107(1):256 [MEDLINE]
- Frequency and importance of barotrauma in 100 patients with acute lung injury. Crit Care Med. 1995;23(2):272 [MEDLINE]
- Clinical risk factors for pulmonary barotrauma: a multivariate analysis. Am J Respir Crit Care Med. 1995;152(4 Pt 1):1235 [MEDLINE]
- Closure of a bronchopleural fistula using decalcified human spongiosa and a fibrin sealant. Ann Thorac Surg. 1997;64(1):230 [MEDLINE]
- The relation of pneumothorax and other air leaks to mortality in the acute respiratory distress syndrome. N Engl J Med. 1998;338(6):341 [MEDLINE]
- International consensus conferences in intensive care medicine: Ventilator-associated Lung Injury in ARDS. This official conference report was cosponsored by the American Thoracic Society, The European Society of Intensive Care Medicine, and The Societéde Réanimation de Langue Française, and was approved by the ATS Board of Directors, July 1999. Am J Respir Crit Care Med. 1999;160(6):2118 [MEDLINE]
- Nitric oxide and high frequency jet ventilation in a patient with bilateral bronchopleural fistulae and ARDS. Can J Anaesth. 2000;47(1):53 [MEDLINE]
- The Macklin effect: a frequent etiology for pneumomediastinum in severe blunt chest trauma. Chest. 2001 Aug;120(2):543-7 [MEDLINE]
- Relationship between ventilatory settings and barotrauma in the acute respiratory distress syndrome. Intensive Care Med. 2002;28(4):406 [MEDLINE]
- Airway pressures and early barotrauma in patients with acute lung injury and acute respiratory distress syndrome. Am J Respir Crit Care Med. 2002;165(7):978 [MEDLINE]
- Management of a bronchopleural fistula using differential lung airway pressure release ventilation. J Cardiothorac Vasc Anesth. 2003;17(6):744 [MEDLINE]
- Pneumothorax associated with long-term non-invasive positive pressure ventilation in Duchenne muscular dystrophy. Neuromuscul Disord. 2004 Jun;14(6):353-5 [MEDLINE]
- Incidence, risk factors and outcome of barotrauma in mechanically ventilated patients. Intensive Care Med. 2004;30(4):612 [MEDLINE]
- Management of advanced ARDS complicated by bilateral pneumothoraces with high-frequency oscillatory ventilation in an adult. Br J Anaesth. 2004;93(3):454 [MEDLINE]
- High frequency oscillatory ventilation in the management of a high output bronchopleural fistula: a case report. Can J Anaesth. 2004;51(1):78 [MEDLINE]
- Pneumothorax: an important complication of non-invasive ventilation in neuromuscular disease. Neuromuscul Disord. 2004 Jun;14(6):351-2 [MEDLINE]
- Use of a modified endobronchial tube for mechanical ventilation of patients with bronchopleural fistula. Eur J Cardiothorac Surg. 2005;28(1):169 [MEDLINE]
- Independent lung ventilation in the management of traumatic bronchopleural fistula. Am Surg. 2006;72(6):530 [MEDLINE]
- Occurrence of pneumothorax during noninvasive positive pressure ventilation through a helmet. J Clin Anesth. 2007 Dec;19(8):632-5 [MEDLINE]
- Extracorporeal membrane oxygenator as a bridge to successful surgical repair of bronchopleural fistula following bilateral sequential lung transplantation: a case report and review of literature. J Cardiothorac Surg. 2007;2:28 [MEDLINE]
- [Evaluation of the incidence of pneumothorax and background of patients with pneumothorax during noninvasive positive pressure ventilation]. Nihon Kokyuki Gakkai Zasshi. 2008 Nov;46(11):870-4 [MEDLINE]
- Benefits and complications of noninvasive mechanical ventilation for acute exacerbation of chronic obstructive pulmonary disease. Rev Bras Ter Intensiva. 2008 Jun;20(2):184-9 [MEDLINE]
- Independent lung ventilation in the postoperative management of large bronchopleural fistula. J Thorac Cardiovasc Surg. 2010;139(2):e21 [MEDLINE]
- Neuromuscular blockers in early acute respiratory distress syndrome. N Engl J Med. 2010;363(12):1107 [MEDLINE]
- Pressure and volume limited ventilation for the ventilatory management of patients with acute lung injury: a systematic review and meta-analysis. PLoS One. 2011;6(1):e14623 [MEDLINE]
- Intrabronchial valves: a case series describing a minimally invasive approach to bronchopleural fistulas in medical intensive care unit patients. J Bronchology Interv Pulmonol. 2012 Apr;19(2):137-41 [MEDLINE]
- Neuromuscular blocking agents in acute respiratory distress syndrome: a systematic review and meta-analysis of randomized controlled trials. Crit Care. 2013 Mar;17(2):R43 [MEDLINE]
- Differential lung ventilation and venovenous extracorporeal membrane oxygenation for traumatic bronchopleural fistula. Ann Thorac Surg. 2013;96(5):1859 [MEDLINE]
- Pulmonary interstitial emphysema in adults: a clinicopathologic study of 53 lung explants. Am J Surg Pathol. 2014 Mar;38(3):339-45 [MEDLINE]
- Pressure-controlled versus volume-controlled ventilation for acute respiratory failure due to acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). Cochrane Database Syst Rev. 2015;1:CD008807 [MEDLINE]
- Independent lung ventilation in the management of ARDS and bronchopleural fistula. Heart Lung. 2016;45(3):258 [MEDLINE]
- High-Frequency Oscillatory Ventilation (HFOV) as Primary Ventilator Strategy in the Management of Severe Acute Respiratory Distress Syndrome (ARDS) with Pneumothorax in the Setting of Trauma. Am Surg. 2017;83(5):525 [MEDLINE]
- Positive pressure ventilation in a patient with a right upper lobar bronchocutaneous fistula: right upper bronchus occlusion using the cuff of a left-sided double lumen endobronchial tube. J Anesth. 2017;31(4):627 [MEDLINE]
- Bronchopleural Fistula Resolution with Endobronchial Valve Placement and Liberation from Mechanical Ventilation in Acute Respiratory Distress Syndrome: A Case Series. Case Rep Crit Care. 2017;2017:3092457 [MEDLINE]
Vocal Cord Granuloma
- Laryngotracheal injury due to endotracheal intubation: incidence, evolution, and predisposing factors. A prospective long-term study. Crit Care Med. 1983;11(5):362 [MEDLINE]
- Resolution of laryngeal injury following translaryngeal intubation. Am Rev Respir Dis. 1992;145(2 Pt 1):361 [MEDLINE]
- Post-intubation laryngeal injuries and extubation failure: a fiberoptic endoscopic study. Intensive Care Med. 2010 Jun;36(6):991-8. doi: 10.1007/s00134-010-1847-z [MEDLINE]
Vocal Cord Paralysis
- Age and comorbidity as risk factors for vocal cord paralysis associated with tracheal intubation. Br J Anaesth. 2007 Apr;98(4):524-30 [MEDLINE]
Vocal Cord Ulceration
- Laryngotracheal injury due to endotracheal intubation: incidence, evolution, and predisposing factors. A prospective long-term study. Crit Care Med. 1983;11(5):362 [MEDLINE]
- Post-intubation laryngeal injuries and extubation failure: a fiberoptic endoscopic study. Intensive Care Med. 2010 Jun;36(6):991-8. doi: 10.1007/s00134-010-1847-z [MEDLINE]