A Study of Various Risk Factors Affecting Tracheal Wall Microstructure in Intubated Patients

INTRODUCTION: Trachealstenosis is one of the complications associated with endotracheal intubation. This study aimed to reveal the effects of various risk factors associated with endotracheal intubation on tracheal microstructure. OBJECTIVE: To study the effects of various risk factors associated with endotracheal intubation on tracheal microstructure. This includes all intubated patients with various underlying conditions irrespective of the duration of intubation, mainly in anticipation of prolonged intubation. METHODS: A prospective study was conducted on 50 critically ill intubated patients. The tracheostomy operation was performed on individual patients who were not intubated for more than 10 days. A part of the anterior tracheal wall was removed and subjected tohistopathological examination (HPE) to assess inflammation, mucosal ulceration, submucosal gland damage, perichondrial changes, cartilage necrosis, squamous metaplasia and fibrosis. RESULTS: Significant changes in histopathological findings were found as the duration of intubation increased. Additionally, significant findings in histopathology were found in patients with any of these risk factors, such as diabetesmellitus (DM), organophosphorus poisoning (OPP), steroid use, and gastroesophageal reflux disease (GERD) (P <0.05). CONCLUSION: This study revealed that various risk factors associated with endotracheal intubation can cause significant changes in tracheal microstructure. More studies with large samples are needed to determine the histopathological changes leading to laryngotracheal stenosis.