Intubaatio

Intubaatio is the placement of an endotracheal tube into the trachea to secure the airway, enable ventilation, and protect against aspiration. It is commonly performed during anesthesia and in critically ill or injured patients who require assisted breathing or airway protection. The procedure may be performed via the mouth (orotracheal) or the nose (nasotracheal).

Indications for intubation include general anesthesia with mechanical ventilation, airway obstruction, coma or reduced consciousness, respiratory failure, risk of aspiration, or anticipated need for prolonged ventilation. It is often planned for elective surgery or performed emergently in the setting of severe trauma, shock, or respiratory arrest.

Techniques and equipment involve visualization of the vocal cords with a laryngoscope, either direct or video-assisted, to place the endotracheal tube. Equipment typically includes an endotracheal tube, a laryngoscope, a stylet, a syringe for cuff inflation, suction, and a bag-valve-mask for ventilation. Rapid sequence induction may be used in emergency or trauma cases to reduce aspiration risk. Placement is confirmed by capnography (exhaled CO2), auscultation of both lungs, observation of symmetrical chest rise, and, when available, imaging.

Potential complications include hypoxia during the attempt, misplacement into the esophagus, dental or soft tissue injury, airway trauma, cuff overinflation, right mainstem bronchus intubation, pneumothorax, and post-extubation airway swelling. Proper technique, ongoing monitoring, and adequate training help minimize risks.

Intubation requires specialized training and experience and is performed by anesthesiologists, emergency medicine clinicians, critical care physicians, and other trained professionals. Guidelines emphasize pre-assessment, appropriate equipment and personnel, use of alternative airway devices as needed, and careful postoperative management.