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January 27, 1969

Laryngotracheal Damage After Prolonged Use of Orotracheal Tubes in Adults

Author Affiliations

From the departments of anesthesiology (Drs. Hedden, Ersoz, and Safar) and pathology (Dr. Donnelly), University of Pittsburgh School of Medicine and Presbyterian-University Hospital, Pittsburgh.

JAMA. 1969;207(4):703-708. doi:10.1001/jama.1969.03150170029005

Laryngotracheal damage after prolonged retention of orotracheal tubes (one to ten days) in adults was reviewed in 116 unselected patients admitted to an intensive care unit. Among the 59 survivors, all patients who had the tube in place for more than 48 hours had temporary difficulties with orally taken fluids for several hours after extubation. In two of five survivors having the tube in place for more than 72 hours, hoarseness (two patients) and aspiration (one patient) were irreversible. In 27 of 57 patients who died, the larynges and tracheas were examined and scored postmortem for lesions. Scores increased with duration of intubation. Retention of tracheal tubes for less than 72 hours was rarely followed by serious lesions. Six of seven patients who had the tube in place for more than 72 hours showed high scores.