Evaluation of laryngopharyngeal effects in patients long-term intubated

Eda Şimşek; Ziya Şimşek; Eyüp Serhat Çalık; Fatih Bingöl; Ayşe Çarlıoğlu; Muhammed Recai Mazlumoğlu; Enise Koza; Bilgehan Erkut

doi:10.18663/tjcl.382946

Research Article

Uzun süreli entübasyon yapılmış hastalarda laringofaringeal etkilerin değerlendirilmesi

Year 2018, , 131 - 136, 18.07.2018

Eda Şimşek , Ziya Şimşek , Eyüp Serhat Çalık , Fatih Bingöl Ayşe Çarlıoğlu , Muhammed Recai Mazlumoğlu Enise Koza Bilgehan Erkut

https://doi.org/10.18663/tjcl.382946

Abstract

Amaç,:
Açık kardiyovasküler cerrahiler hem operasyon süresi hem de postoperatif yoğun
bakımda takip süresi göz önüne alındığında entübasyon süresinin uzun olduğu
bilinen ameliyatlardır. Biz bu çalışmada koroner cerrahisi sonrası uzun süre entübe kalmış hastalarda
postoperatif dönemde gözlenen laringeal ve faringeal etkilenmeyi incelemek ve
bu etkilerin oluşumuna zemin hazırlayan olası nedenleri araştırmayı amaçladık.

Materyal ve Metodlar: Çalışmaya
kardiyovasküler cerrahi yapılan toplam 42 hasta dahil edildi. Tüm hastalar
preoperatif (preop) dönemde ve postoperatif dönemde (ortalama 7.gün) endoskopik
muayene edildi ve muayene bulguları kaydedildi.

Bulgular: Hastalar
ortalama 61±9.98 yaşında, ortalama entübe kalma süresi 14.80±3.41saat,
kullanılan entübasyon tüpünün iç çapı 8.02±0.4 mm idi. Preoperatif sigara içen
hasta sayısı 25 (%59.52) ve preoperatif gastroözofageal reflü semptomu olan
hasta sayısı 8 (% 19.04 ). Postoperatiflaringeal ve faringeal patolojik bulgu
oranı %38.09 bulundu. Postoperatif laringeal ve faringeal patolojik bulgu olan
hastalarda yaş, entübasyon süresi, preoperatif gastroözofageal reflü hastalığı
şikayeti arasındaki ilişki isitatiksel açıdan anlamlı bulundu (p˂0,05).Ancak postoperatif
patolojik bulgu ile cinsiyet, entübasyon tüpünün tipi ve çapı, sigara kullanma arasında anlamlı ilişki bulunmadı.

Sonuç:
Yaş, gastroözofageal
reflü hastalığı varlığı, entübasyon süresinin uzunluğu postoperatif laringofaringeal
bulgu oluşumu için risk faktörü olarak tespit edildi.

Keywords

Endotrakeal entübasyon, larinks, farinks, koroner cerrahi

References

1. Skoretz SA, Yau TM, Ivanov J, Granton JT, Martino R. Dysphagia and Associated Risk Factors Following Extubation in CardiovascularSurgical Patients. Dysphagia 2014; 29: 647–54
2. House JC, Noordzij PJ, Murgia B, Langmore S. Laryngeal Injury From Prolonged Intubation: A Prospective Analysis of Contributing Factors. Laryngoscope 2011; 121: 596–600.
3. Mendels EJ, Brunings JW, Hamaekers AW, Stokroos RJ, Kremer B, BaijensLW. Adverse Laryngeal Effects Following Short-term General Anesthesia A SystematicReview. Arch Otolaryngol Head Neck Surg 2012; 138: 257-64
4. Mota LA, Cavalho GB, Brito VA. Laryngeal complications by orotracheal intubation: Literaturereview .Int. Arch. Otorhinolaryngol 2012; 16: 236-45.
5. Mencke T, Echternach M, Kleinschmidt S, Lux P, Barth V, Plinkert PK, Buder TF. Laryngeal Morbidity and Quality of Tracheal Intubation A Randomized Controlled Trial. Anesthesiology 2003; 98: 1049–56
6. Bouabdallaoui N, Stevens SR, Doenst T et al. Impact of Intubation Time on Survival following Coronary Artery Bypass Grafting: Insights from the Surgical Treatment for Ischemic Heart Failure (STICH) Trial.J Cardiothorac Vasc Anesth 2017; 23: 31030-33.
7. Belafsky PC, Postma GN, Koufman JA. Validity and reliability of the reﬂux symptom index (RSI). J Voice 2001; 16: 27–47
8. Su H. et al. Tongue Weakness and Somatosensory Disturbance Following Oral Endotracheal Extubation. Dysphagia 2015; 30: 188–95
9. Hamdana AL, Moukarbela RV, Farhata F, Obeidb M. Vocal cord paralysis after open-heart surgery. Eur J Cardiothorac Surg 2002; 21: 671–74
10. Yuan SM. Hoarseness subsequent to cardiovascular surgery, intervention, maneuver and endotracheal intubation: Theso-callediatrogenic Ortner’s (cardiovocal) syndrome revıew artıcle. Cardiology Journal 2012; 19: 560–66.
11. Rangachari V, Sundararajan I, SumathiV, Kumar KK. Laryngeal sequelae following prolonged intubation: A prospectivestudy. Indian J Crit Care Med 2006; 10: 171-75
12. Azarfarin R, Ashouri N, Totonchi Z, Bakhshandeh H, Yaghoubi AR. Factors Influencing Prolonged ICU Stay After Open Heart Surgery. Res Cardiovasc Med 2014; 3: 20159
13. Silva CE, Niedermeier BT, Portinho F. Reﬂux Laryngitis: Correlation between the Symptoms Findings and Indirect Laryngoscopy. Int Arch Otorhinolaryngol 2015; 19: 234–37.
14. Martinucci I et al. Optimal treatment of laryngopharyngeal reflux disease. Ther Adv Chronic Dis 2013; 4: 287 –301
15. Bain WM, Harrington JW, Thomas LE, Schaefer SD. Head and neck manifestations of gastroesophageal reflux. Laryngoscope 1983; 93: 175-79.
16. Johnson KN, Botros DB, Groban L, Bryan YF. Anatomic and physiopathologic changes affecting the airway of the elderly patient: implications for geriatric-focused airway management. Clinical Interventions in Aging 2015; 10: 1925–34.
17.Branski RC, Zhou H, KrausDH, Sivasankar M. The Effects of Cigarette Smoke Condensate on Vocal Fold Transepithelial Resistance and Inflammatory Signaling in Vocal Fold Fibroblasts. Laryngoscope 2011; 121: 601–05
18. Geraci G, Cupido F, LoNigro C, Sciuto A,Sciumè C,Modica G. Postoperative laryngeal symptoms in a general surgery setting. Clinical study. Ann Ital Chir 2013; 84: 377-78

Evaluation of laryngopharyngeal effects in patients long-term intubated

Year 2018, , 131 - 136, 18.07.2018

Eda Şimşek , Ziya Şimşek , Eyüp Serhat Çalık , Fatih Bingöl Ayşe Çarlıoğlu , Muhammed Recai Mazlumoğlu Enise Koza Bilgehan Erkut

https://doi.org/10.18663/tjcl.382946

Abstract

Aim:
Open
cardiovascular surgery involves prolonged intubation, postoperatively in the
intensive care unit monitoring. The purpose of this study was to investigate the
effects of long-term intubation after coronary artery surgery on laryngeal and
pharyngeal structures and the probable underlying causes for such effects.

Material
and Methods: Forty two
patients undergoing cardiovascular surgery were included in the study. All
patients underwent endoscopic examination in the preoperative period and approximately
7th postoperative day.

Results:
Mean age of the
patients was 61±9.98 years, mean duration of intubation was 14.80±3.41 hours
(h) and mean size of intubation tube used was 8.02±0.45 mm. The number of
preoperative smokers was 25(59.52%), and number of patients with preoperative
gastroesophageal reflux disease symptoms were 8(19.04%). The level of
postoperative laryngeal and pharyngeal pathological findings were 38.09%.
Postoperative laryngeal and pharyngeal pathological findings were correlated
with age, length of intubation and preoperative presence of the
gastroesophageal reflux disease symptoms (p˂0.05). However, no statistically
significant correlation was determined between postoperative pathological
finding and sex, tube type, tube diameter, smoking status.

Conclusion:
Age, presence of
gastroesophageal reflux disease, length of intubation were identified as risk
factors for the development of postoperative pathological laryngopharyngeal
findings.

Keywords

Endotracheal intubation, larynx, pharynx, coronary surgery

References

1. Skoretz SA, Yau TM, Ivanov J, Granton JT, Martino R. Dysphagia and Associated Risk Factors Following Extubation in CardiovascularSurgical Patients. Dysphagia 2014; 29: 647–54
2. House JC, Noordzij PJ, Murgia B, Langmore S. Laryngeal Injury From Prolonged Intubation: A Prospective Analysis of Contributing Factors. Laryngoscope 2011; 121: 596–600.
3. Mendels EJ, Brunings JW, Hamaekers AW, Stokroos RJ, Kremer B, BaijensLW. Adverse Laryngeal Effects Following Short-term General Anesthesia A SystematicReview. Arch Otolaryngol Head Neck Surg 2012; 138: 257-64
4. Mota LA, Cavalho GB, Brito VA. Laryngeal complications by orotracheal intubation: Literaturereview .Int. Arch. Otorhinolaryngol 2012; 16: 236-45.
5. Mencke T, Echternach M, Kleinschmidt S, Lux P, Barth V, Plinkert PK, Buder TF. Laryngeal Morbidity and Quality of Tracheal Intubation A Randomized Controlled Trial. Anesthesiology 2003; 98: 1049–56
6. Bouabdallaoui N, Stevens SR, Doenst T et al. Impact of Intubation Time on Survival following Coronary Artery Bypass Grafting: Insights from the Surgical Treatment for Ischemic Heart Failure (STICH) Trial.J Cardiothorac Vasc Anesth 2017; 23: 31030-33.
7. Belafsky PC, Postma GN, Koufman JA. Validity and reliability of the reﬂux symptom index (RSI). J Voice 2001; 16: 27–47
8. Su H. et al. Tongue Weakness and Somatosensory Disturbance Following Oral Endotracheal Extubation. Dysphagia 2015; 30: 188–95
9. Hamdana AL, Moukarbela RV, Farhata F, Obeidb M. Vocal cord paralysis after open-heart surgery. Eur J Cardiothorac Surg 2002; 21: 671–74
10. Yuan SM. Hoarseness subsequent to cardiovascular surgery, intervention, maneuver and endotracheal intubation: Theso-callediatrogenic Ortner’s (cardiovocal) syndrome revıew artıcle. Cardiology Journal 2012; 19: 560–66.
11. Rangachari V, Sundararajan I, SumathiV, Kumar KK. Laryngeal sequelae following prolonged intubation: A prospectivestudy. Indian J Crit Care Med 2006; 10: 171-75
12. Azarfarin R, Ashouri N, Totonchi Z, Bakhshandeh H, Yaghoubi AR. Factors Influencing Prolonged ICU Stay After Open Heart Surgery. Res Cardiovasc Med 2014; 3: 20159
13. Silva CE, Niedermeier BT, Portinho F. Reﬂux Laryngitis: Correlation between the Symptoms Findings and Indirect Laryngoscopy. Int Arch Otorhinolaryngol 2015; 19: 234–37.
14. Martinucci I et al. Optimal treatment of laryngopharyngeal reflux disease. Ther Adv Chronic Dis 2013; 4: 287 –301
15. Bain WM, Harrington JW, Thomas LE, Schaefer SD. Head and neck manifestations of gastroesophageal reflux. Laryngoscope 1983; 93: 175-79.
16. Johnson KN, Botros DB, Groban L, Bryan YF. Anatomic and physiopathologic changes affecting the airway of the elderly patient: implications for geriatric-focused airway management. Clinical Interventions in Aging 2015; 10: 1925–34.
17.Branski RC, Zhou H, KrausDH, Sivasankar M. The Effects of Cigarette Smoke Condensate on Vocal Fold Transepithelial Resistance and Inflammatory Signaling in Vocal Fold Fibroblasts. Laryngoscope 2011; 121: 601–05
18. Geraci G, Cupido F, LoNigro C, Sciuto A,Sciumè C,Modica G. Postoperative laryngeal symptoms in a general surgery setting. Clinical study. Ann Ital Chir 2013; 84: 377-78

There are 18 citations in total.

Details

Primary Language	English
Subjects	Health Care Administration
Journal Section	Orıgınal Artıcle
Authors	Eda Şimşek Ziya Şimşek Eyüp Serhat Çalık Fatih Bingöl This is me Ayşe Çarlıoğlu Muhammed Recai Mazlumoğlu This is me Enise Koza This is me Bilgehan Erkut
Publication Date	July 18, 2018
Published in Issue	Year 2018

Cite

APA	Şimşek, E., Şimşek, Z., Çalık, E. S., Bingöl, F., et al. (2018). Evaluation of laryngopharyngeal effects in patients long-term intubated. Turkish Journal of Clinics and Laboratory, 9(2), 131-136. https://doi.org/10.18663/tjcl.382946
AMA	Şimşek E, Şimşek Z, Çalık ES, Bingöl F, Çarlıoğlu A, Mazlumoğlu MR, Koza E, Erkut B. Evaluation of laryngopharyngeal effects in patients long-term intubated. TJCL. June 2018;9(2):131-136. doi:10.18663/tjcl.382946
Chicago	Şimşek, Eda, Ziya Şimşek, Eyüp Serhat Çalık, Fatih Bingöl, Ayşe Çarlıoğlu, Muhammed Recai Mazlumoğlu, Enise Koza, and Bilgehan Erkut. “Evaluation of Laryngopharyngeal Effects in Patients Long-Term Intubated”. Turkish Journal of Clinics and Laboratory 9, no. 2 (June 2018): 131-36. https://doi.org/10.18663/tjcl.382946.
EndNote	Şimşek E, Şimşek Z, Çalık ES, Bingöl F, Çarlıoğlu A, Mazlumoğlu MR, Koza E, Erkut B (June 1, 2018) Evaluation of laryngopharyngeal effects in patients long-term intubated. Turkish Journal of Clinics and Laboratory 9 2 131–136.
IEEE	E. Şimşek, Z. Şimşek, E. S. Çalık, F. Bingöl, A. Çarlıoğlu, M. R. Mazlumoğlu, E. Koza, and B. Erkut, “Evaluation of laryngopharyngeal effects in patients long-term intubated”, TJCL, vol. 9, no. 2, pp. 131–136, 2018, doi: 10.18663/tjcl.382946.
ISNAD	Şimşek, Eda et al. “Evaluation of Laryngopharyngeal Effects in Patients Long-Term Intubated”. Turkish Journal of Clinics and Laboratory 9/2 (June 2018), 131-136. https://doi.org/10.18663/tjcl.382946.
JAMA	Şimşek E, Şimşek Z, Çalık ES, Bingöl F, Çarlıoğlu A, Mazlumoğlu MR, Koza E, Erkut B. Evaluation of laryngopharyngeal effects in patients long-term intubated. TJCL. 2018;9:131–136.
MLA	Şimşek, Eda et al. “Evaluation of Laryngopharyngeal Effects in Patients Long-Term Intubated”. Turkish Journal of Clinics and Laboratory, vol. 9, no. 2, 2018, pp. 131-6, doi:10.18663/tjcl.382946.
Vancouver	Şimşek E, Şimşek Z, Çalık ES, Bingöl F, Çarlıoğlu A, Mazlumoğlu MR, Koza E, Erkut B. Evaluation of laryngopharyngeal effects in patients long-term intubated. TJCL. 2018;9(2):131-6.