急性心脏事件插管后获得性喉气管狭窄

文献信息

中文摘要

目的： 获得性喉气管狭窄（ALTS）是气管插管后的并发症，与插管时间延长和气管导管尺寸较大相关。然而，其与心血管疾病的关系尚未被探讨。
方法： 我们回顾性审查了2013年至2023年在Temple University Health System医院因急性心脏事件插管后诊断为获得性喉气管狭窄的成年患者。非心脏原因插管后的获得性喉气管狭窄患者作为对照。比较两组之间的气管导管尺寸和插管时间。
结果： 研究组有10例患者发生获得性喉气管狭窄，而对照组为21例患者（0.27% vs. 1.23%；p < 0.0001）。两组在人口统计学或插管时间方面无差异。急性心脏事件患者使用较小的气管导管插管（p = 0.023），并且需要的插管尝试次数较少（p = 0.04）。
结论： 心脏相关插管后获得性喉气管狭窄的发生率较低，可能归因于较小的气管导管尺寸和较少的插管尝试，但其他因素可能也有作用。
证据等级： III。

英文摘要

OBJECTIVES: Acquired laryngotracheal stenosis (ALTS) is a complication after endotracheal intubation, associated with prolonged intubation and larger endotracheal tube size. However, the relationship with cardiovascular disease has not been explored.
METHODS: We retrospectively reviewed adult patients diagnosed with acquired laryngotracheal stenosis after acute cardiac event intubation at Temple University Health System hospitals from 2013 to 2023. Acquired laryngotracheal stenosis patients after non-cardiac intubation served as controls. Endotracheal tube size and length of intubation were compared between the two groups.
RESULTS: Ten patients developed acquired laryngotracheal stenosis in the study group compared to 21 control patients (0.27 percent vs. 1.23 percent; p < 0.0001). Groups did not differ in demographics or length of intubation. Acute cardiac event patients were intubated with a smaller endotracheal tube (p = 0.023) and required fewer intubation attempts (p = 0.04).
CONCLUSIONS: Acquired laryngotracheal stenosis incidence was lower after cardiac-related intubation, potentially due to a smaller endotracheal tube size and fewer intubation attempts, but additional factors may be responsible.
LEVEL OF EVIDENCE: III.