Secuelas laringotraqueales post intubación endotraqueal prolongada. Laringotracheal Sequelar post a long-term endotracheal intubation
Abstract
Se realizó examen macro y microscópico de la laringe y métodos y primeros anillo traqueales a la totalidad de los pacientes fallecidos en los Servicios de Cuidados Intensivos y Servicios de Cuidados Intermedios del Hospital Provincial Docente "Abel Santamaría", entre enero de 1993y diciembre de 1994, los que a causa de su afección de base, mantuvieron intubación endotraqueal por periodos mas o menos prolongados. Así mismo, todo egresado vivo de dicho servicios en igual periodo, con síntomas sospechosos de daño larigotraqueal post intubación, fue explorado por laringoscopia indirecta y/o directa y traqueoscopía. En ambos casos se comprobó la alta frecuencia de lesiones en el segmento laringotraqueal de diversos tipos y estadios, en estrecho vinculo esto ultimo con el tiempo de intubación. Se constata también que ya las tres horas existe daño visible de la mucosa por isquemia compresiva, lesión que se profundiza y agrava a medida que se prolonga el tiempo de intubación, derivándose de ello la gran importancia del cumplimiento estricto de determinadas medidas profilácticas.
DeCS: ESTENOSIS, ESTENOSIS TRAQUEAL, LARINGOESTENOSIS, INTUBACION/efecto adverso, LARIGE/análisis.
ABSTRACT
A macro and microscopic study of the larynx and the first tracheal rings was carried out in all the patients who died at the special care services (ICU) of Abel Santamaria General Hospital, between January, 1993 and December, 1994. These patients had had endotracheal intubation for a more or less prolonged period. Likewise, indirect and/or direct laryngoscopy and tracheoscopy were performed in all the survivors suspected to have postintubation laryngotracheal damage. The high frequency of lesions of diverse types and stages in the laryngotracheal segment was evident in both cases and closely related to intubation time. This investigation confirms the development of a visible damage of the mucosa.
DeCS: STENOSIS, TRACHEAL STENOSIS, LARYNGOSTENOSIS, INTUBATION/ adverse effects, LARYNX/ analysis.
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