Possible complications after extubation

This is an automatically translated article.

The article is professionally consulted by Specialist Doctor I Tran Thi Ngat - Department of General Surgery - Vinmec Danang International General Hospital.

1. What is endotracheal intubation?

Endotracheal intubation is a procedure in which a catheter is inserted into the patient's trachea to ensure ventilation and drain sputum stagnation in the airways. This is a simple trick, easy to do, but extremely important. In case the patient needs an emergency, the endotracheal intubation procedure should be performed quickly and promptly, in order not to cause complications due to the delay in opening the patient's airway.

2. Complications may be encountered when tracheal extubation

2.1. Technical complications Bleeding stroke due to the endotracheal tube is too large, the force of pushing the tube will cause bleeding in the airways such as the anterior nostril, the back of the throat, the vocal cords and the trachea. Causes infection: due to the poor aseptic process, there is rubbing of the tracheal wall. Complications caused by the endotracheal tube entering the esophagus.

2.2. Possible complications when extubating Laryngeal spasm Complications: Causes sudden, severe laryngeal dyspnea and cyanosis immediately after extubation. Treatment by nebulizing adrenaline, must immediately check the endotracheal tube, remove the ambu balloon tube. If unsuccessful, intubation or tracheostomy for emergency delivery. Complications causing laryngeal edema: Laryngeal dyspnea appears gradually, after many minutes or hours. Treat by nebulizing adrenaline and hydrocortisone. If not successful, intubation or tracheostomy. Complications causing stenosis or polyps of the airways - bronchi: need bronchoscopy for treatment. Complications of rhinitis, pharyngitis or laryngitis. Complications cause edema, tracheal ulcers, leading to narrowing of the trachea. A dangerous complication is sudden reflex cardiac arrest, which is a very common complication in patients with hypoxia. In addition, complications after extubation can also cause atelectasis due to the endotracheal tube entering deep into the bronchial branches or causing sputum obstruction in the endotracheal tube.

3. Indications and contraindications of intubation technique

The endotracheal intubation procedure has no absolute contraindications. However, it may be relatively contraindicated in cases of malnutrition, hypoalbuminemia, chest wall edema, severe infections, respiratory tract infections, especially hospital-acquired pneumonia (although not respiratory failure).

4. Caring for intubated patients

Care of intubated patients should be careful to avoid dangerous complications. Care is as follows:
For the patient, it is necessary to fix the hand so that the patient does not arbitrarily withdraw the tube. Aspirate blood from the patient's throat and endotracheal tube, monitor and handle complications according to medical orders. Aspirate sputum every 30 minutes. Injecting into the patient's endotracheal tube 1ml of 14% sodium bicarbonate solution or α-Chymotrypsin helps to thin sputum and limit bacterial infections. Rinse the sputum straw and soak it in an antiseptic solution. Monitor pulse, temperature, blood pressure, breathing rate every 1 hour or every 3 hours as ordered by the treating doctor. Reassess the patient's condition: degree of cyanosis, consciousness. Intubation is a simple procedure, easy to perform but extremely important, if you encounter small mistakes, it can also leave dangerous complications after extubation. Therefore, patients should choose reputable addresses with good expertise to perform this procedure.
Vinmec International General Hospital is a general hospital with the function of examining, treating and recovering many diseases with modern medical equipment, and technical items are also invested in appropriate innovation. With each procedure, surgery is different to minimize possible dangerous complications. Especially with a team of highly qualified and well-trained doctors and nurses, they will bring optimal treatment results to customers.
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