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Medical professionals use intubation, the process of inserting a tube into the stomach or trachea, to increase airflow or open airways, to provide nutrients, or for the administration of medication. Intubation trauma is a general term used to describe an injury to the nose, mouth, throat, stomach, or endolaryngeal structures as a direct result of intubation. Typically, intubation trauma is the result of improper placement of an intubation tube, poorly chosen tubes, preexisting medical conditions, or the prolonged use of intubation. Injuries can range from simple inflammation to lesions, perforations, ulcers, or the development of nodules.
Doctors and healthcare providers choose to use intubation for a variety of health situations, including routine administration of anesthesia or medical emergencies. Depending on the specific situation, a medical professional might insert a tube through the nose or mouth. Tubes may be feed from the nose to the trachea, the nose to the stomach, the mouth to the trachea, or the mouth to the stomach. In an emergency situation where the patient's airway is blocked due to trauma or medical emergency, the patient can also be intubated through an incision in the throat. Each of these methods poses opportunities for different types of intubation trauma or injuries.
According to the strict definition of the term, intubation trauma is a wound or shock to the systems involved in intubation. While many intubation injuries do happen during the process of inserting tubes into a patient, some injuries are the result of prolonged use of an intubation tube. Severity of the injury depends on the cause. For example, a poorly placed tube can cause lesions in the mucosa around endolaryngeal structures or in the nasal passages. Poor selection of tube size, and even some types of tubes, can cause inflammation to the larynx and other soft tissue structures.
Examples of intubation trauma include gastric perforation; lesions on the muscosa of the pharynx, larynx, or esophagus; perforation of soft tissues in the neck or throat; as well as damage to the vocal cords. Excessive force is the most common cause behind such intubation trauma. Inexperienced practitioners are the most likely to cause intubation injuries, especially those resulting from inadvertently feeding the tube through the esophageal tract rather than through the trachea. Formation of ulcers and nodules can result from intubation trauma, causing problems with breathing and speaking. Treatment for an injury resulting from intubation varies, depending on the placement of the injury, its cause, and its severity.
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