Laryngotracheal complications after intubation for COVID-19: a multicenter study.

Many of the patients with COVID-19 have suffered respiratory distress requiring prolonged endotracheal intubation (ETI) resulting in laryngotracheal complication with an impact on breathing, phonation, and swallowing. Our aim is to describe laryngeal injuries diagnosed after ETI in patients with COV...

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Detalles Bibliográficos
Autores: Hernández-García, Estefanía, Hernández-Sandemetrio, Rosa, Quintana-Sanjuás, Ana, Zapater-Latorre, Enrique, González-Herranz, Ramón, Sanz López, Lorena, Reboll, Rosa, Pallarés-Martí, Beatriz, Ollé-Moliner, Montserrat, Martínez-Pascual, Paula, Gotxi, Itziar, Chacón-Uribe, Araly, Plaza, Guillermo
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universidad Francisco de Vitoria
Repositorio:DDFV. Repositorio Institucional de la Universidad Francisco de Vitoria
Idioma:inglés
OAI Identifier:oai:ddfv.ufv.es:10641/5539
Acceso en línea:https://hdl.handle.net/10641/5539
Access Level:acceso abierto
Palabra clave:Laryngeal complications
COVID-19
Prolonged intubation
Tracheostomy
Subglottic stenosis
Descripción
Sumario:Many of the patients with COVID-19 have suffered respiratory distress requiring prolonged endotracheal intubation (ETI) resulting in laryngotracheal complication with an impact on breathing, phonation, and swallowing. Our aim is to describe laryngeal injuries diagnosed after ETI in patients with COVID-19 in a multicentre study. Methods: A prospective descriptive observational study was conducted from January 2021 to December 2021, including COVID-19 patients with laryngeal complications due to ETI diagnosed in several Spanish hospitals. We analyzed the epidemiological data, previous comorbidities, mean time to ICU admission and ETI, need for tracheostomy, mean time on invasive mechanical ventilation until tracheostomy or weaning, mean time in ICU, type of residual lesions, and their treatment. Results: We obtained the collaboration of nine hospitals during the months of January 2021 to December 2021. A total of 49 patients were referred. Tracheostomy was performed in 44.9%, being late in most cases (more than 7–10 days). The mean number of days of ETI until extubation was 17.63 days, and the main post-intubation symptoms were dysphonia, dyspnea, and dysphagia, in 87.8%, 34.7%, and 42.9%, respectively. The most frequent injury was altered laryngeal mobility, present in 79.6%. Statistically, there is a greater amount of stenosis after late ETI and after delayed tracheostomy, not observing the data with the immobility alterations. Conclusion: The mean number of days of ETI was long, according to the latest guidelines, with the need for several cycles of pronation. This long ETI may have had an impact on the increase of subsequent laryngeal sequelae, such as altered laryngeal mobility or stenosis.