Corrosion casting of the subglottis following endotracheal tube intubation injury: a pilot study in Yorkshire pigletsReportar como inadecuado




Corrosion casting of the subglottis following endotracheal tube intubation injury: a pilot study in Yorkshire piglets - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Journal of Otolaryngology - Head and Neck Surgery

, 42:52

First Online: 14 October 2013Received: 09 May 2013Accepted: 14 September 2013

Abstract

PurposeSubglottic stenosis can result from endotracheal tube injury. The mechanism by which this occurs, however, is not well understood. The purpose of this study was to examine the role of angiogenesis, hypoxia and ischemia in subglottic mucosal injury following endotracheal intubation.

MethodsSix Yorkshire piglets were randomized to either a control group N=3, ventilated through laryngeal mask airway for corrosion casting or accelerated subglottic injury group through intubation and induced hypoxia as per a previously described model N=3. The vasculature of all animals was injected with liquid methyl methacrylate. After polymerization, the surrounding tissue was corroded with potassium hydroxide. The subglottic region was evaluated using scanning electron microscopy looking for angiogenic and hypoxic or degenerative features and groups were compared using Mann–Whitney tests and Friedman’s 2-way ANOVA.

ResultsAnimals in the accelerated subglottic injury group had less overall angiogenic features P=.002 and more overall hypoxic-degenerative features P=.000 compared with controls. Amongst angiogenic features, there was decreased budding P=.000 and a trend toward decreased sprouting P=.037 in the accelerated subglottic injury group with an increase in intussusception P=.004, possibly representing early attempts at rapid revascularization. Amongst hypoxic-degenerative features, extravasation was the only feature that was significantly higher in the accelerated subglottic injury group P=.000.

ConclusionsSubglottic injury due to intubation and hypoxia may lead to decreased angiogenesis and increased blood vessel damage resulting in extravasation of fluid and a decreased propensity toward wound healing in this animal model.

KeywordsSubglottic stenosis Endotracheal tube injury Animal model Corrosion casting Scanning electron microscopy Electronic supplementary materialThe online version of this article doi:10.1186-1916-0216-42-52 contains supplementary material, which is available to authorized users.

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Autor: Lukas H Kus - Michael C Sklar - Jaina Negandhi - Marvin Estrada - Antoine Eskander - Robert V Harrison - Paolo Campisi -

Fuente: https://link.springer.com/



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