Airway Injuries During Orotracheal Intubation: Risk Factors, Prevention, and Management

• DOI: https://doi.org/10.22533/at.ed.1594852417092

• Palavras-chave: Orotracheal intubation; Airway trauma; Laryngoscopy; Intubation complications; Airway management strategies.

• Keywords: Orotracheal intubation; Airway trauma; Laryngoscopy; Intubation complications; Airway management strategies.

• Abstract: INTRODUCTION The introduction provides an overview of orotracheal intubation, including its definition, purposes, and indications across various clinical settings. It highlights the evolution of intubation techniques and the anatomical and physiological changes associated with the procedure. The introduction identifies the types and prevalence of airway injuries, discusses the risk factors involved, and explores the impact of different intubation techniques and equipment on injury rates. It also covers the role of training and experience, challenges in emergency situations, complications associated with airway injuries, and their significance in special populations. The introduction concludes by addressing current prevention strategies, technological advances, and existing controversies and gaps in knowledge. OBJETIVE To comprehensively review the incidence, risk factors, types, diagnostic approaches, and management strategies associated with airway injuries during orotracheal intubation, while evaluating the effectiveness of current prevention and treatment methodologies. METHODS This is a narrative review which included studies in the MEDLINE – PubMed (National Library of Medicine, National Institutes of Health), COCHRANE, EMBASE and Google Scholar databases, using as descriptors: “Orotracheal Intubation” OR “Airway Injury” AND “Airway Management” OR “Intubation Complications” AND “Laryngoscopy Techniques” in the last  years. RESULTS AND DISCUSSION The results and discussion section evaluates the impact of patient demographics, comorbidities, and anatomical variations on airway injury risk. It explores the correlation between intubation duration, tools, and settings on injury severity and incidence, comparing direct laryngoscopy with video laryngoscopy and other advanced techniques. The discussion examines outcomes in different populations, the role of early detection methods, and therapeutic approaches for managing airway injuries. It highlights clinical guidelines, preventive measures, and diagnostic tools, while also considering the economic, ethical, and systemic factors influencing injury rates. The section concludes by identifying future research priorities and the need for tailored prevention programs in different healthcare settings. CONCLUSION The conclusion emphasizes the significance of airway injuries during orotracheal intubation and their implications for patient safety, outcomes, and healthcare resources. It calls for a multidisciplinary approach to prevention, diagnosis, and management, recognizing the complexity of factors contributing to these injuries. While acknowledging advancements in training and technology, the conclusion identifies gaps in knowledge, particularly regarding optimal management strategies and long-term outcomes. It advocates for continued research, innovation, and enhanced communication among healthcare providers to minimize the incidence and impact of airway injuries in clinical practice.