Modern possibilities of correction of consequences of prolonged intubation
Ovchinnikov A.Yu., Miroshnichenko N.A., Gorban D.G., Ekaterinchev V.A., Zamanov M.U.

A. I. Yevdokimov Moscow State University of Medicine and Dentistry

The article presents the incidence of respiratory tract damage during intubation and prolonged artificial lung ventilation (ALV), based on the own experience of the authors and literature data. The article gives the analysis of the causes and factors of damage to the larynx and trachea from the standpoint of anesthesiologists, emergency physicians and otorhinolaryngologists, as well as a complex of organizational, diagnostic and therapeutic measures aimed at their prevention and treatment. Conservative therapy of inflammatory changes in the larynx and trachea in patients after ventilation is extremely multifaceted and includes a number of well-known components: antimicrobial and respiratory therapy, physiotherapy, immunotherapy, restorative treatment and much more. The article defines the time of the «tracheostomy» during the ventilation, the algorithm for the dekanulation of patients. In cases of development of cicatricial stenosis of the larynx and / or trachea the conservative methods of treatment are used, as well as the surgery methods with endo / extra laryngeal or endo / extra tracheal approaches. The role of endoscopy in the diagnosis and treatment of post-intubation and posttracheostomic injuries of the larynx and trachea is described, and schemes for the rational pharmacotherapy of inflammatory changes in the respiratory tract are given.

Key words: tracheal intubation, artificial lung ventilation, tracheostomy, decanulation, erosive tracheitis, laryngostenosis, tracheal stenosis, videoimage laryngo-tracheal bronchoscopy.
For citation: Ovchinnikov A. Yu., Miroshnichenko N. A., Gorban D. G. et al. Modern possibilities of correction of consequences 
of prolonged intubation // RMJ. 2018. № 3(II). P. 62–66.