REVIEW article
Front. Med. Technol.
Sec. Diagnostic and Therapeutic Devices
Volume 7 - 2025 | doi: 10.3389/fmedt.2025.1667748
Endotracheal intubation-related oral mucosal membrane pressure injuries: A narrative review of biomechanical insights, biomaterial optimization, and intelligent monitoring
Provisionally accepted
- 1First Affiliated Hospital of Kunming Medical University, Kunming, China
- 2Ganmei Affiliated Hospital of Kunming Medical University (The First People's Hospital of Kunming), Kunming, China
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Objectives: This article is a narrative review that synthesizes current evidence on orotracheal intubation-related oral mucosal membrane pressure injuries in intensive care unit (ICU) patients, focusing on mechanisms, risk factors, and prevention strategies. The review is intended to inform clinicians and researchers by integrating insights from intensive care, biomechanics, biomaterials, and oral microbiology. Methods: A comprehensive literature search was conducted in PubMed, Web of Science, Embase, and CNKI using the terms “orotracheal intubation”, “oral mucosal injury”, “device-related pressure injury”, “biomechanics”, “biomaterials” and “oral microbiome”. Studies published between 2000 and 2025, including both clinical and experimental research, were considered without language restrictions. Results: Evidence indicates that vertical pressure, shear force, and friction from endotracheal tubes are key contributors to oral mucosal injury. Reported risk factors include advanced age, prolonged intubation, malnutrition, and inflammation. Preventive strategies have been explored in four domains: biomechanical modeling using finite element analysis, biomaterial optimization such as hydrogel and nanocoatings, regulation of the oral microecosystem through probiotics, and intelligent monitoring systems incorporating artificial intelligence and Internet of Things technologies. Conclusions: Orotracheal intubation-related oral mucosal pressure injuries are multifactorial and preventable. This narrative review integrates biomechanical insights, optimized biomaterials, microbiome regulation, and intelligent monitoring into a multidimensional prevention framework. Such strategies may enhance early identification, reduce complications, and improve clinical outcomes in ICU patients.
Keywords: Orotracheal intubation, oral mucosal membrane pressure injury, microecosystem regulation, orotracheal, oral mucosal membrane
Received: 24 Jul 2025; Accepted: 23 Sep 2025.
Copyright: © 2025 Cai, Li, Liu, Ma, Zhang, Li and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Na Li, dxhhpjdr@hotmail.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.