Intubation trauma

It is a common practice in general anaesthesia to intubate patients with a cuffed endotracheal tube which is inflated to produce an air-tight fit. Damage to the upper respiratory tract was occasionally associated with endotracheal intubation before relaxants were widely used,lS2 but, since these drugs have come to be employed routinely, lesions from the anaesthetic use of intubation have not been reported and recorded complications have generally followed periods of intubation in excess of 24 hours.3 It is thus assumed that short periods of endotracheal intubation produce no damage to the mucosa of the upper respiratory tract. The absence of complications following short periods of intubation during anaesthesia could be because the tracheal mucous membrane remains undamaged, or it might be that damaged tissues have healed so rapidly that complications have not occurred. Recent work in calves4 and pigs5 has shown that mucosal damage is detectable after a period of intubation lasting 3 hours. This paper reports a study of tracheal damage produced by intubation and various periods of cuff inflation in pigs.