Background: Prolonged intubation in intensive care patients is associated with laryngeal injury. The recognition of laryngeal injury by nasoendoscopy examination is not routine clinical practice following extubation. This study aimed to determine if bedside voice assessments provide clinical utility as a simple screening tool to identify laryngeal injury in patients following extubation in the intensive care setting. Methods: Patients intubated for longer than 24 hours were recruited from a tertiary hospital intensive care unit. Bedside voice assessments [S/Z ratio, GRBAS, Consensus Auditory Perceptual Evaluation-Voice (CAPE-V)] and laryngeal endoscopic examination were conducted initially at 24-48 hours and repeated at 5-7 days after extubation. Voice outcomes were correlated with endoscopic findings. Results: Initial assessments were conducted in 60 participants, with 37 participants completing the second assessment. The median [interquartile range (IQR)] duration of intubation was 60.1 (38.2-136.5) hours. The prevalence of endoscopic laryngeal injury was 92% at 24 hours and remained high (78%) at 5 days post extubation. The most common injury type was vocal process ulceration/granuloma (in 84% of patients). Bedside voice assessments detected 100% of patients had dysphonia at 24 hours, but did not correlate with the presence of laryngeal injury. Conclusions: Laryngeal injury and dysphonia are prevalent following a prolonged period of intubation. Bedside voice assessments do not correlate with the type or severity of laryngeal injury. It is important to be aware of the high prevalence of laryngeal injury in this population following prolonged intubation.
|Number of pages||13|
|Journal||Australian Journal of Otolaryngology|
|Publication status||Published - Apr 2022|
- intensive care
- Laryngeal injury