Keywords
Estenosis traqueal
Traqueostomía
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Abstract
Objective: To analyze the relationship between prolonged orotracheal intubation (OTI) and the occurrence of tracheal stenosis, describe the profile of affected patients, and identify the minimum time required for the onset of stenosis. Methods: An integrative literature review was conducted using the LILACS, PubMed, and MEDLINE databases, filtering studies published in the last 15 years. The descriptors used were “tracheal stenosis,” “orotracheal intubation,” and “thoracic surgery” in Portuguese and English. After applying screening and inclusion criteria, 15 articles were selected from an initial total of 37. Results: Findings indicate that while there is no precise minimum number of days for the onset of stenosis, mucosal injury may begin after 48 hours of OTI. A significant increase in the risk of stenosis is noted after 14 days. Additional risk factors include trauma during laryngoscopy and excessive cuff pressure, which can lead to tracheal wall ischemia and chronic inflammation. Final considerations: Tracheal stenosis is a serious complication of prolonged OTI. Early recognition of risk factors and implementation of preventive strategies are crucial to reducing incidence and improving patient outcomes.
References
ALVARADO-SARZOSA F, et al. Reconstrucción de estenosis traqueal benigna: experiencia de un hospital de alta complejidad en Colombia. Revista Colombiana de Cirugía, 2021; 37(1): 43-48.
ANDRADE PDM, et al. Estenose traqueal pós-ventilação mecânica em pacientes acometidos pela Covid-19: evento isolado ou complicação direta?. Revista Eletrônica Acervo Científico, 2021; 31: 8376-8388.
BRODERICK N, STRAKER T. Tracheal stenosis. In: STRAKER T e RAJAN S (org.). Anesthesiology: A Problem-Based Learning Approach. Oxford University Press, 2018; p. 325–334.
CAMPOS NF, et al. Efeitos da intubação orotraqueal na voz e deglutição de adultos e idosos. Distúrbios da Comunicação, 2017; 28(4).
CUESTAS G, et al. Granuloma laríngeo posintubación: una rara complicación de la intubación traqueal en pediatría. Caso clínico. Archivos Argentinos de Pediatria, 2017; 115(5): 315-318.
DORRIS ER, et al. Post-intubation subglottic stenosis: aetiology at the cellular and molecular level. European Respiratory Review, 2021; 30(159): 200218-200228.
FARZANEGAN R, et al. Incidence Rate of Post-Intubation Tracheal Stenosis in Patients Admitted to Five Intensive Care Units in Iran. Iranian Red Crescent Medical Journal, 2016; 18(9): 1-10.
FARZANEGAN R, et al. Postintubation multisegmental tracheal stenosis: a 24-year experience. The Annals of Thoracic Surgery, 2021; 112(4): 1101–1108.
GHIANI A, et al. Tracheal stenosis in prolonged mechanically ventilated patients: prevalence, risk factors, and bronchoscopic management. BMC Pulmonary Medicine, 2022; 22(1): 1-9.
LI M, et al. Risk Factors for Posttracheostomy Tracheal Stenosis. Otolaryngology–Head and Neck Surgery, 2018; 159(4): 698-704.
LYBERIS P, et al. IgG4-infiltrate in post-intubation tracheal stenosis: a call to interventional pulmonologist and thoracic surgeons. Minerva Surgery, 2023; 78(5): 33-36.
MATTIOLI F, et al. Post-intubation tracheal stenosis in COVID-19 patients. European Archives of Oto-Rhino-Laryngology, 2021; 278(3): 847–848.
PIAZZA C, et al. Long‑term intubation and high rate of tracheostomy in COVID‑19 patients might determine an unprecedented increase of airway stenoses: a call to action from the European Laryngological Society. European archives of Oto-Rhino-Laryngology, 2020; 278(1): 1-7.
SIDDIQUI S. Wheeze or stridor? A careful listening to prevent impending respiratory doom. Clinical Medicine (London, England), 2024; 24: 100044.
SOUZA LGD, et al. Intubação Orotraqueal e suas complicações: uma revisão de literatura. Brazilian Journal of Health Review, 2021; 4(3): 15458-15470.
WAIN JC. Postintubation Tracheal Stenosis. Seminars in Thoracic and Cardiovascular Surgery, 2009; 21(3): 284-289.
WRIGHT CD, et al. Postintubation tracheal stenosis: management and results 1993 to 2017. The Annals of Thoracic Surgery, 2019; 108(5): 1471–1477.
YANKOV G, et al. Two cases with postintubation tracheal stenosis after COVID-19 pneumonia. Monaldi Archives for Chest Disease, 2023; 1-10.
ZIAS N, et al. Post tracheostomy and post intubation tracheal stenosis: report of 31 cases and review of the literature. BMC Pulmonary Medicine, 2008; 8(1): 18-28.
ZAYAS ACOSTA R, et al. High tracheal stenosis due to prolonged intubation. Health Leadership and Quality of Life, 2024; 3.