What are the complications of intubation?

Complications of intubation include a false intubation, where the tube is inserted into the esophagus instead of the trachea. This means that the patient is not ventilated and does not receive oxygen. If the false intubation is not detected in time, the lack of oxygen can lead to permanent damage or even death.

Even if intubation into the trachea is carried out, complications in the form of damage through the tube can occur. Examples of this are luxation of the ary cartilage in the larynx or other damage to the vocal cords, e.g. intubation granuloma, which can lead to hoarseness and breathing difficulties, among other things. Damage to the trachea (windpipe) is also possible.

This can lead to subglottic stenosis, which can make breathing difficult. Another complication is the injury or loss of teeth due to incorrect use of the laryngoscope. In long-term ventilated patients, the tube can lead to injuries to the mucous membrane of the trachea and even necrosis.

You can find additional information under: The risks of general anesthesia Intubation granuloma is a form of vocal fold granuloma that can occur as a complication of endotracheal long-term intubation. It is a pseudotumor, i.e. a tumor that takes up space but otherwise does not have the characteristics of a real tumor. Another example of a pseudotumor are warts.

A vocal fold granuloma is usually preceded by an injury of the vocal fold. In the case of intubation granuloma this is the intubation. Symptoms are coughing, hoarseness, foreign body sensation and breathing difficulties.

The treatment is carried out by surgical removal of the granuloma. Since the vocal fold is injured again by the operation, recurrences are not rare. Inflammation of the epiglottis (epiglottitis) occurs mainly in small children, but in rare cases adolescents and adults may also be affected.

Since sterile instruments and materials are used for intubation, it is rather unlikely to be the cause. There is a vaccination against the pathogen Haemophilus influenzae, which is also recommended for every child. Since epiglottitis has a rather high mortality rate of 10-20%, rapid administration of antibiotics is important.

In case of emergency even an intubation has to be performed to secure the airways. In the case of endotracheal intubation, a tube is placed in the trachea to ensure the patient’s ventilation. This can also cause various intubation damages.

One of the most common complaints after awakening from anesthesia is hoarseness. This should disappear one or two days after the operation. In some cases, e.g. by moving the tube, it can lead to additional irritation of the vocal cords, which makes the hoarseness last longer.

Long-term intubation increases the chances of injury to the vocal cords and the formation of an intubation granuloma, which in turn can cause hoarseness until it is removed. In rare cases, intubation can also injure the muscles and nerves that are responsible for moving the vocal folds. This can then lead to paralysis of the vocal folds and long-lasting hoarseness. In principle, endotracheal intubation does not have to be performed for every procedure. If necessary, ask the anesthesiologist about possible alternatives.