Complications de l'intubation endo-tracheale et de la tracheotomie Etude retrospective de 797 cas

A retrospective study of complications of endotracheal intubation and tracheostomy is realized on 797 patients admitted in the center of intensive care and emergency medecine [CAMU] of Tunis upon a period of 5 years between 1988 and 1992. During this period 14 cases of laryngotracheal stenosis are identified; 8 cases following endotracheal intubation and 6 cases following tracheostomy. The evolution of these stenosis, in spite of treatment is caracterized by a high mortality [42,8%]. The determinants of laryngotracheal stenosis with P values 11 days, a frequency of self extubation >/= 2, a frequency of reintubation >/= 3, the existence of a nosocomial comial pulmonary infection and/or a shock of reventilation. These findings confirm the complexity of mechanisms of laryngotracheal injury and underline the importance of their prevention. So the authors recommend the pratice of tracheostomy before 10 days of intubation to prevent the complications of prolonged endotracheal intubation