Prolonged (therapeutic) endotracheal intubation

Abstract

Summary: In recent years there has been an increased use of therapeutic intubation. It is especially useful in conscious patients postoperatively for periods of a day or so when the need for respiratory assistance is short-lived. It can be utilized for many days but the likelihood of laryngeal damage is probably increased, although in the individual case the shortness of the period of intubation is no guarantee of laryngeal safety. Whether the advantages of prolonged intubation outweigh the disadvantages can only be decided when the results of a series of carefully followed-up cases of prolonged intubation can be compared with those of a series of patients who have a tracheostomy inserted early in their treatment and for approximately the same length of time as the endotracheal tube. The frequency and type of laryngeal pathology suggest that therapeutic intubation should not be used for more than a few hours if there is not a strong indication for an artificial airway, but the incidence of damage is not so high as to contraindicate a prospective study comparing it with tracheostomy under apparently the same conditions. © 1968 John Sherratt and Son Ltd.