Laryngotracheal Complications of Endotracheal Intubation

Laryngeal and tracheal specimens from 64 autopsy patients, 41 intubated and 23 non-intubated, were studied macro-and microscopically. The age of 64 patients varied from 1 month to 83 years. Intubated patients had endotracheal tubes continuously until their death, and the duration ranged 12 minutes to 521 hours.Following results were obtained:1) The most common lesions encountered were posterior ends of vocal cords, lateral and posterior walls of subglottis, and anterior and lateral walls of 5th and 9th tracheal cartilages, and also their neighbouring tracheal cartilages.2) Mucous ulceration was found in 10 percent of specimens intubated less than 24 hours, but it was observed in all specimens intubated more than 3 days.3) It is desirable to alternate endotracheal intubation with tracheostomy within 24 hours, at least within 48 hours.