Laryngotracheal injuries following mechanical ventilation
Research type
Research Study
Full title
An investigation of the incidence of laryngotracheal stenosis following mechanical ventilation in intensive care, means of predicting its occurrence and of the feasibility of post-ICU screening.
IRAS ID
164542
Contact name
Edward Costar
Contact email
Sponsor organisation
Imperial College London
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
The use of endotracheal and tracheostomy tubes to provide mechanical ventilation is at the core of intensive care treatment. One of the recognised complications of providing mechanical ventilation via tubes with cuffs which provide an air-tight seal is damage to the trachea, or windpipe, which can later manifest as difficulty in breathing caused by narrowing of the trachea (tracheal stenosis). This may be mild and slowly progressive, mimicking other conditions such as asthma or heart failure, or it may present with sudden, life-threatening airway obstruction.
This study is designed to assess the risk of developing tracheal stenosis after a period of ventilation by following up patients who have left intensive care and monitoring them for symptoms and signs of narrowing of the trachea. This will be done using questionnaires and spirometry, a non-invasive airflow test. By examining patients ventilated via tracheostomy tubes and endotracheal tubes it will be possible to determine whether one type of airway or the other poses a greater risk.
It is also designed to assess whether it is possible to predict the later development of tracheal stenosis by examining the lining of the trachea for signs of damage with a fibreoptic camera at the time the breathing tube is removed.
By comparing the incidence of tracheal stenosis derived from this study with existing data on the numbers of stenoses presenting to ENT surgeons, and with data for the number of episodes of ventilation across the UK per year, it is intended to calculate the likely number of undetected cases of stenosis occurring each year. This will form the basis of an economic analysis of the merits of screening for post-ICU tracheal stenosis.
REC name
East of England - Essex Research Ethics Committee
REC reference
15/EE/0225
Date of REC Opinion
17 Aug 2015
REC opinion
Further Information Favourable Opinion