Middle ear effusion in intensive care unit patients with prolonged endotracheal intubation

Objectives: The purpose of this study is to explore the factors related to the occurrence of middle ear effusion (MEE) in prolonged endotracheal intubation patients in the intensive care unit (ICU). Methods: Information about the age, sex, duration of endotracheal intubation, level of consciousness, and placement of nasogastric tube was retrospectively collected from medical charts of 20 prolonged endotracheal intubation (>7 days) patients in the ICU. All patients received otoscopic examination, tympanometry studies, and spectral gradient acoustic reflectometry for evidence of MEE. Results: Among the 40 ears examined in this study, 20 ears had MEE (50%), 14 ears were normal (35%), and 6 ears had negative pressure in the middle ear (15%). In addition, patients with conscious disturbance and those who had been intubated for 14 days had a significantly higher incidence of MEE. Nasogastric tube was not implicated in MEE in this study. No episodes of acute otitis media or systemic infection were encountered in this study. Conclusions: Prolonged endotracheal intubation (>7 days) in adult ICU patients contributed to the high incidence of MEE (50%). Moreover, conscious disturbance and endotracheal intubation for 14 days were also significant contributing factors of MEE.