INTENSIVE CARE  SMART 2003 - Milan, may 28-30, 2003 Free access

Minerva Anestesiologica 2003 May;69(5):348-52

Copyright © 2003 EDIZIONI MINERVA MEDICA

language: English

Nasal vs oral intubation

Holzapfel L.

Service de réanimation, Centre Hospitalier, Bourg en Bresse, France

Both nasal and oral route for intubation have advantages and disadvantages. Oral intubation is easier to perform, faster and less painful than nasal intubation under direct laryngoscopy, while blind nasal intubation represents a good alternative in conscious patient, without sedation. In trauma patient, oral route should be preferred, with cervical immobilisation. By the contrary, nasal intubation can cause bleeding, retro-pharyngeal and turbinate bones injury, but it seems preferable in preventing laryngeal complications. Moreover nasal intubation seem to increase risk for sinusitis while, there is no clear advantage for any of the two routes, concerning nosocomial pneumonia, bacteriemia and otitis. Nevertheless nasal route increases comfort for the patient and decreases injury and necrosis of tongue and lips; tube fastening is simpler thus reducing accidental extubation.