Browsing by Author "Cabrera López, José María"

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    Role of Prolonged Intubation in Vocal Fold Motion Impairment in Critically Ill Patients
    (2024) Cabrera López, José María; Lagos Villaseca, Antonia Elisa; Fuentes López, Eduardo; Rosenbaum Fuentes, Andrés Ricardo; Willson Easton, Matías Iñigo; Palma Rojas, Soledad De Los Ángeles; Kattan Tala, Eduardo José; Vera Alarcón, María Magdalena; Aquevedo Salazar, Andrés Fernando; Napolitano Valenzuela, Carla Andrea; Cabello Estay, Pablo Andrés
    Summary: Objective. COVID-19 upsurge in orotracheal intubation (OTI) has opened a new opportunity for studying associated complications. Vocal fold motion impairment (VFMI) is a known complication of OTI. The present study sought to determine the impact of OTI and prolonged OTI on the risk of developing VFMI; to identify both risk and protective factors associated with it. Study design. Retrospective cohort study. Setting. Multicenter. Methods. Medical charts were reviewed for all patients that received invasive mechanical ventilation with a subsequent flexible laryngoscopic assessment between March 2020 and March 2022. The main outcomes were the presence of VFMI, including immobility (VFI) and hypomobility (VFH). Results. A total of 155 patients were included, 119 (76.8%) COVID-19 and 36 (23.2%) non-COVID-19 patients; overall 82 (52.9%) were diagnosed with VFMI. Eighty (52.3%) patients underwent a tracheostomy. The median (IQR) intubation duration was 18 (11–24.25) days, while the median (IQR) time to tracheostomy was 22 (16–29). In the adjusted model, we observed there was a 68% increased risk for VFMI from day 21 of intubation (RR: 1.68; 95% CI 1.07–2.65; P = 0.025). Conclusions. VFMI is a frequent complication in severely ill patients that undergo intubation. A prolonged OTI was associated with an increased risk of VFMI, highlighting the importance of timely tracheostomy. Further research is needed to confirm these findings in other subsets of critically ill patients.