PATHOMORPHOLOGICAL CHANGES IN THE CARTILAGE OF THE TRACHEA DEPENDING ON TERMS OF THE INTUBATION

Objective - to study the nature and prevalence of pathological changes in the cartilage of the trachea depending on the duration of intubation according to the results of pathomorphological studies. Materials and methods. Pathomorphological study of cartilage of the anterior tracheal wall was carried out on 37 patients at different times of mechanical ventilation. Depending on the timing of the ventilator before the tracheostomy, all patients were divided into three groups. In 10 people, the duration of ventilation until tracheostomy was no more than 3 days, in 15 people - 4 -7 days and in 12 people - more than 7 days. Results. On the 1st day of mechanical ventilation, dystrophic changes are determined, with the loss of cartilage cells. On the 2nd day of mechanical ventilation in the cartilage of the trachea significant dystrophic changes with pycnosis of the nuclei in chondrocytes were revealed. By the third day of mechanical ventilation, detachment of perichondria occurred, the surface of cartilage lacking perichondria was usurized, covered with fibrinous overlays, the cartilage no longer contained cartilage cells; by the 7th day of mechanical ventilation, deeper dystrophic and destructive changes were revealed in the tracheal cartilages - there was no perichondria, the cartilage surface was usurized, foci of chondronecrosis were observed in the areas adjacent to the damaged perichondria; by the tenth days of mechanical ventilation, the pathomorphological picture indicates the death of the cartilage and its replacement with granulation tissue, the presence of regeneration processes, expressed in focal proliferation of chondrocytes, thickening and fibrosis of the perichondria, the appearance and sequestration of dead cartilage. Conclusion. The severity of pathomorphological changes in the cartilage of the trachea due to the duration of intubation