Complications of intubation

The complications of Intubation can be divided into perioperative, postoperative and delayed complications.

Perioperative Complications of intubation :

• Esophageal intubation: This is a hazardous complication If not detected in time can cause severe hypoxia and even death.
• Ischemia, edema and necrosis at local site (especially with red rubber tubes).
• Aspiration (if cuff is not properly inflated).
• Bronchial intubation and collapse of other lung:
• Tracheal tube obstruction by secretions, kinking. Again if not detected in time can cause hypoxia.
• Accidental extubation.
• Trauma to gums, lip, epigiottis, pharynx, larynx and nasal cavity (in nasal Intubation)
• Reflex disturbances like laryngospasm, bronchospasm and breath holding.
• Cardiac arrhythmias, hypertension or even cardiac arrest.

Postoperative Complications of intubation :

• Sore throat (pharyngitis or laryngitis): This is the most common of all the postoperative complications of intubation. It usually subsides in 2 to 3 days without any treatment.
• Laryngeal edema (usually present after 1 to 2 hours).
• Laryngeal nerve palsies.
• Surgical emphysema and mediastinal emphysema.
• Infection: Pneumonia, lung abscess, mediastinitis.
• Lung atelectasis

Delayed Complications of intubation :

• Vocal cord granuloma.
• Laryngotracheal web.
• Tracheal stenosis.
• Tracheal collapse.

These complications of intubation are seen after prolonged intubation in intensive care patients. Maximum permissible time for which an endotracheal tube can be kept is 21 days. After this period there occurs subglottic edema so, if the requirement is more than this then tracheostomy should be done.