Following extubation a patient may develop laryngeal edema, which may be severe enough to require reintubation. The severity of the edema can be graded based on the clinical findings.


Categories of laryngeal edema:

(1) major

(2) minor

(3) subclinical


Features of major laryngeal edema:

(1) severe respiratory distress

(2) evidence of airway obstruction on laryngoscopy

(3) need for reintubation



• Respiratory distress is characterized by a prolonged inspiratory phase with use of the accessory muscles.

• Direct examination of the airway following extubation is usually avoided if possible because of the risk to the patient.


Features of minor laryngeal edema:

(1) presence of stridor on inspiration (with a high-pitched wheeze)

(2) mild to moderate respiratory distress

(3) need for medical intervention but not reintubation


Features of subclinical laryngeal edema:

(1) absence of significant respiratory distress

(2) no need for clinical intervention


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