NDLI: Clinical review: Post-extubation laryngeal edema and extubation failure in critically ill adult patients

Content Provider	Springer Nature : BioMed Central
Author	Wittekamp, Bastiaan HJ van Mook, Walther NKA Tjan, Dave HT Zwaveling, Jan Harm Bergmans, Dennis CJJ
Abstract	Laryngeal edema is a frequent complication of intubation. It often presents shortly after extubation as post-extubation stridor and results from damage to the mucosa of the larynx. Mucosal damage is caused by pressure and ischemia resulting in an inflammatory response. Laryngeal edema may compromise the airway necessitating reintubation. Several studies show that a positive cuff leak test combined with the presence of risk factors can identify patients with increased risk for laryngeal edema. Meta-analyses show that pre-emptive administration of a multiple-dose regimen of glucocorticosteroids can reduce the incidence of laryngeal edema and subsequent reintubation. If post-extubation edema occurs this may necessitate medical intervention. Parenteral administration of corticosteroids, epinephrine nebulization and inhalation of a helium/oxygen mixture are potentially effective, although this has not been confirmed by randomized controlled trials. The use of non-invasive positive pressure ventilation is not indicated since this will delay reintubation. Reintubation should be considered early after onset of laryngeal edema to adequately secure an airway. Reintubation leads to increased cost, morbidity and mortality.
Related Links	https://ccforum.biomedcentral.com/counter/pdf/10.1186/cc8142.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
ISSN	13648535
DOI	10.1186/cc8142
Journal	Critical Care
Issue Number	6
Volume Number	13
Language	English
Publisher	BioMed Central
Publisher Date	2009-12-01
Access Restriction	Open
Subject Keyword	Intensive Critical Care Medicine Emergency Medicine Airway Obstruction Extubation Failure Laryngeal Edema Early Tracheostomy Inspiratory Stridor
Content Type	Text
Resource Type	Review
Subject	Critical Care and Intensive Care Medicine
Journal Impact Factor	8.8/2023
5-Year Journal Impact Factor	10.4/2023

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Postextubation laryngeal edema and stridor resulting in respiratory failure in critically ill adult patients: updated review

Clinical review: Post-extubation laryngeal edema and extubation failure in critically ill adult patients

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