Tracheal and laryngeal trauma leading to an<unk>  are caused by traumas during the<unk>  processes, directly resulting from technical circumstances such as specifications of the breathing tube equipment, method of insertion, and<unk>  duration.235x235pxIntubation duration Statistically, patients intubated for more than 48 hours will experience some form of laryngeal injury attributed to<unk> , and approximately half of the injuries will result in the development of granulation tissue in the vocal fold. While there is no consensus on the maximal permissible duration of safe endotracheal<unk> , the risk of trauma-related laryngeal<unk>  formation increases significantly with prolonged durations of tracheal<unk> . However, there are also studies which have not found statistically significant correlations between prolonged<unk>  duration with the degree of laryngeal injury, and<unk>  cases have also been reported in patients who have been intubated for only a few hours.<unk>  tube diameter Appropriate<unk>  tube sizes are defined as those small enough to minimise risks of mucosal trauma while large enough to maintain adequate ventilation. This is especially important in the field of pediatrics, where the development of a child’s trachea may vary according to age. Age-based calculations of appropriately sized<unk>  tubes are conducted in accordance with the Khine formula, which are based on internal diameters. Unfortunately, these formulas do not account for variances in outer diameter and cuff dimensions, which may result in varying tube sizes. Alternatively, height-based calculations are also available. According to PALS (2010) guidelines, the use of length-based resuscitation tapes has proven to be more accurate than age-based estimates of endotracheal<unk>  tubes. Cuff pressure The addition of an endotracheal tube cuff decreases the likelihood of selecting oversized breathing tubes for the patient, while also preventing microaspiration and the leakage of respiratory gases during<unk> . However, hyperinflation of the cuff places excessive pressure on the tracheal wall, causing trauma or ischaemia to nearby tissue and hence increasing the risk of<unk>  formation. Cuff pressures can be monitored during endotracheal<unk>  via manometers to prevent nitrous oxide induced hyperinflation. General guidelines suggest that cuff pressure should be maintained between 20 to 30 cm to minimise risks of<unk> -related trauma.
Intubation granuloma
Bronchopleural fistula
Pleural empyema
Aspiration pneumonia
Fibrothorax
Lobar pneumonia
Lung abscess
Urinothorax