Tympanometric evaluations of intubated patients

Introduction: The follow-up of the patients in intensive care unit is an important and difficult issue that requires a multidisciplinary study. Communication with patients who are often unconscious and dependent on the ventilator may not possible to establish, and some diseases may be overlooked. However, in addition to the clinical consequences for health, the assessment of the overall health status outcomes is also important in assessing the quality of life and in terms of the risk of infection. For these reasons, in our study, tympanometric evaluations of intubated patients in intensive care unit are done and nasogastric tube (NGT) and GAG (swallowing) reflex is followed up in terms of how they reflected to tympanometric values. Materials and Methods: 64 patients with NGT (24 males, 42 females) and 30 patients without NGT were included our study. 20 of them have gag reflex, 44 do not have gag reflex. In addition, a healthy control group was created with 30 volunteer (15 male, 15 female) in parallel with the follow-up days in intensive care unit, to assess how the individual's measurements on different days affect the tympanometric values. Tympanometric measurements of the study group and the control group were performed on day 1, day 4, day 7, day 14, and day 21 and alterations in compliance and pressure values were followed. Results: In the intensive care unit, the data showed that the prolonged period of intubation is parallel to the development of effusion serous otitis media has been obtained. In the nasal cavity side where the NGT was placed, serous otitis development started earlier and it has been observed that the diameters of the NGTs in the various numbers are significantly reflected in the tympanomic measurements. Also, in comparison with patients who have GAG reflex, tympanometry values in the early stages of prolonged intubation times of patients without GAG reflex were adversely affected. Conclusion: In this sense, the periodic follow-up of intensive care patients with prolonged intubation will be beneficial via otoscopic examination and tympanometric measurements against possible middle ear infections and preferably the smallest diameter nasogastric tubes should be used.