Department of Chest Surgery, National Health Insurance Cooperation ILSAN Hospital, Goyang, Korea
ABSTRACT
Postintubation injury became a significant problem with the advent of mechanical ventilation support using cuffed endotracheal tube. Serious damages occurred because of pressure ischemia under the small volume, noncompliant inflatable cuffs that were used during early years. Having identified the pathophysiology of the injuries, currently used endotracheal and tracheostomy tube with large volume, low pressure cuff have developed and the incidence of postintubation injury is now markedly reduced. But intubation related complications still occur due to prolonged intubation or malposition of tracheostomy tube. Life threatening emergent postintubation complications were TIF (Tracheoinnominate artery fistula), TEF (Tracheoesophageal fistula), Tension pneumothorax, and pneumomediastinum. These complications were rare but life threatening, and so prevention is very important. This report reviews the etiology, diagnosis, treatment, and prevention of the postintubation complication.