Acquired Laryngotracheal Stenosis Following Intubation for Acute Cardiac Events

Abstract Objectives Acquired laryngotracheal stenosis (ALTS) is a complication after endotracheal intubation, associated with prolonged intubation and larger endotracheal tube size. However, the relationship with cardiovascular disease has not been explored. Methods We retrospectively reviewed adult patients diagnosed with acquired laryngotracheal stenosis after acute cardiac event intubation at Temple University Health System hospitals from 2013 to 2023. Acquired laryngotracheal stenosis patients after non-cardiac intubation served as controls. Endotracheal tube size and length of intubation were compared between the two groups. Results Ten patients developed acquired laryngotracheal stenosis in the study group compared to 21 control patients (0.27 percent vs. 1.23 percent; p < 0.0001). Groups did not differ in demographics or length of intubation. Acute cardiac event patients were intubated with a smaller endotracheal tube ( p = 0.023) and required fewer intubation attempts ( p = 0.04). Conclusions Acquired laryngotracheal stenosis incidence was lower after cardiac-related intubation, potentially due to a smaller endotracheal tube size and fewer intubation attempts, but additional factors may be responsible. Level of Evidence III