Complications after extubation

This is an automatically translated article.

The article is professionally consulted by Master, Doctor Phan Ngoc Toan - Emergency Medicine Doctor - Emergency Department - Vinmec Danang International Hospital.

1. The concept of intubation

Endotracheal intubation is a procedure performed urgently in patients with respiratory failure either indicated or performed surgically. Before endotracheal intubation, the patient is usually given a sedative and muscle relaxant. A flexible plastic tube is then inserted into the trachea, usually through the mouth, to help the patient receive ventilation. The size of the breathing tube will be selected according to the patient's age and throat size.
The purpose of endotracheal intubation is to ensure ventilation to the lungs in situations of severe respiratory failure due to medical disease, serious trauma or during surgery.

2. Complications after extubation

2.1. Laryngeal spasms Laryngeal spasms usually occur when the airways are irritated during superficial anesthesia. Common irritations are increased secretions, or blood, in the upper respiratory tract; inhalation of pungent anesthetics, placement of pharyngeal and nasopharyngeal cannulas, laryngoscopy, surgery in the mouth...
Reflex closes the vocal cords, causing partial or total obstruction. In non-severe cases, wheezing or stridor may be heard.
Laryngeal spasm causes hypoxia, excess CO2 in the blood, mixed acidosis and consequently high arterial blood pressure and rapid pulse. This condition can progress very quickly to cause arrhythmias, low blood pressure, and cardiac arrest if the airway is not cleared quickly within a few minutes.
To manage this condition, the doctor needs to give the patient aerosol adrenaline. In the event that this complication still cannot be overcome, the doctor needs to appoint an emergency intubation or tracheostomy.
2.2. Laryngeal edema This is a complication very close to laryngospasm. The cause is an allergy to the endotracheal tube or its lubricant, or it may be due to the size of the endotracheal tube being larger than the patient's, or because the previous intubation process was difficult and had to be carried out. act many times.
Edema of the larynx may appear with signs such as hoarseness, wheezing. To accurately diagnose this complication, it is necessary to rely on direct laryngoscopy.
The patient will experience laryngeal dyspnea and this comes on gradually. It may be minutes or hours after extubation. Manage this complication by nebulizing adrenaline and hydrocortisone. If the patient's condition still does not improve, the doctor should recommend intubation or tracheostomy.

2.3 Other complications

Chronic hoarseness of voice Swallowing disorder Tracheostomy - Tracheoesophageal fistula (rare) Tracheo-arterial fistula (rare) Aspiration pneumonia... Vinmec International General Hospital is a general hospital with the function of visiting examination, treatment and rehabilitation of many diseases with modern standard medical equipment. Accordingly, the technical equipment is also invested in innovation suitable for each procedure and surgery in order to minimize possible dangerous complications, including the intubation procedure. manage. Especially with a team of highly qualified and well-trained doctors and nurses, they will bring optimal treatment results to customers.
Master Phan Ngoc Toan used to work as a Internal Medicine Doctor at Quang Tri General Hospital, Emergency and Intensive Care Doctor - Hoan My Da Nang Hospital before working at Vinmec International General Hospital. Da Nang as it is today. Doctor Math has a lot of experience in the treatment of Resuscitation – Adult Emergency, Pediatric Emergency.
To register for examination and treatment at Vinmec International General Hospital, you can contact Vinmec Health System nationwide, or register online HERE.
Reference source: healthline.com