intubointia

Intubointia is a term used in some speculative medical writings to describe a hypothetical syndrome involving chronic inflammatory and fibrotic changes of the upper and lower airway associated with endotracheal intubation. It is not a formally recognized diagnosis in major medical guidelines and has not been established in controlled studies; descriptions are limited to case reports and theoretical reviews.

Clinical features include progressive exertional dyspnea, wheeze, cough, hoarseness, stridor, and recurrent airway infections months after prolonged or multiple intubations. Patients may have persistent airway wall thickening, stenosis, or granulomatous lesions on imaging.

Pathophysiology and risk factors: proposed mechanisms include mechanical trauma from the tube or cuff, ischemic injury to the tracheal mucosa, biofilm formation, and immune-mediated responses leading to chronic inflammation and fibrosis. Risk factors include prolonged intubation, high cuff pressures, reintubation, pediatric age, and repeated airway instrumentation.

Diagnosis: evaluation relies on history of critical illness with intubation, imaging (CT) showing airway narrowing, and bronchoscopy with mucosal lesions. Biopsy may show chronic granulomatous inflammation; microbiological testing helps exclude infection; differential diagnosis includes post-intubation stenosis, granulomatous diseases, infection, and neoplasia.

Management and prognosis: treatment is tailored to severity and may include endoscopic dilation, laser therapy, stenting, or surgical airway reconstruction. Anti-inflammatory or immunomodulatory therapies are reported in limited cases. Antibiotics for concurrent infection. Prognosis varies; some cases stabilize with intervention, while others progress, underscoring the need for early recognition and multidisciplinary care.