Post-intubation Pulmonary Complications:
The Role of Microaspiration

Program Description
Post-intubation pulmonary complications remain one of the leading causes of morbidity and mortality and result in delayed discharge of hospitalized patients, particularly those who have had surgery. These complications have also been a main reason for readmission of surgical patients, imposing substantial financial burden on the health care system. A large study of patients undergoing major non-cardiac surgery indicated that the 30-day postoperative mortality rate in patients who developed pneumonia was 21% versus 2% in those who did not have develop a postoperative pneumonia. Interestingly, while serious postoperative pulmonary complications rival serious cardiac complications in terms of frequency and associated mortality, the former do not often receive as much recognition or attention from clinicians.

While several patient- and procedure-related factors have been linked to increased risk of post-intubation respiratory complications, aspiration of upper airway secretions into the respiratory tract is a major etiologic factor. High-volume low-pressure (HVLP) ET tubes have been designed so that the diameter of the fully inflated cuff is larger than the internal diameter of the trachea, however the folded cuff material often creates small longitudinal ducts and channels that could possibly permit leakage of fluids past the cuff into the respiratory tract, and result in microaspiration. Given the unfavorable outcomes associated with microaspiration of fluids and other materials past the cuff of endotracheal tubes, a number of strategies have been suggested to limit microaspiration.
 
The webcast will address what can be done to minimize mircoaspiration.

Learning Outcomes
By the end of this activity, the learner will be able to:
1. To describe the significance of microaspiration and the reason it happens.
2. To list various strategies to reduce or prevent microaspiration through the cuffs.
3. To explain the limitations of in vitro models and importance of clinical studies to determine the safety and efficacy of new endotracheal tubes.

Presenter
The presenter is Garry Byrdges, DNP, CRNA, ACNP-BC, Chief Nurse Anesthetist at MD Anderson Cancer Center.

CE Accreditation
This program is approved for CE credit. Please follow instructions at the end of the video.

In order to get your Free CE credit please go to www.saxetesting.com