(0203) Acute Laryngeal Injury in Patients Undergoing Tracheostomy for Prolonged Intubation

Introduction: Acute laryngeal injury (ALgI) refers to airway injury due to endotracheal intubation. The goal of this study is to assess the incidence of acute laryngeal injury (ALgI) in patients undergoing tracheostomy for prolonged intubation.

Methods: A retrospective chart review from September 2022 to September 2023 of all patients who underwent tracheostomy for prolonged intubation by the senior author was conducted.

Results: A total of 14 patients underwent tracheostomy for prolonged intubation. Of them, 10 patients were male (71.4%). Average age was 54.8 (±12.3) years old. Average body mass index was 32.5 (±9.7). Average Charlson Comorbidity Index was 3.79 (± 2.6) and 50% (n = 7) of patients had DM. Almost all (92.9%; n = 13) patients were intubated with a 7-5 ETT or larger (75% of women, 100% of men). Length of intubation was 12.8 ± 4.4 days (range 6-21). Direct laryngoscopy at the time of tracheostomy demonstrated ALgI in 100% of patients. Treatment for ALgI at the time of tracheostomy typically included debridement of granulation tissue and triamcinolone injection into the cricoarytenoid joints. Four patients (28.6%) required repeat surgery for treatment of ALgI, and two required extensive reconstruction with airway stenting due to severe laryngeal injury with complete subglottic stenosis. At the time of abstract submission, 57.1% (n = 8) patients were decannulated, 1 patient was still inpatient, 14.2% (n = 2) of patients were persistently dependent on tracheostomy (not due to airway stenosis), 1 patient was deceased (not related to airway), and 14.2% (n=2) were lost to follow up.

Conclusions: In this cohort, ALgI was present in all patients undergoing tracheostomy for prolonged intubation. Early identification and management of ALgI may prevent long-term airway stenosis and tracheostomy dependence.