What individuals would most likely experience stridor after extubation?

Stridor is a high-pitched wheezing sound that occurs when there is a narrowing or obstruction of the airway. After extubation, patients may experience stridor due to various factors related to airway edema or injury.

Individuals with bilateral recurrent laryngeal nerve (RLN) damage are most likely to experience stridor after extubation because this nerve is crucial for the control of the vocal cords. Damage to both sides of the RLN can lead to the inability of the vocal cords to adduct properly, which is necessary for maintaining airway patency. This can result in significant airway obstruction, causing stridor as the patient breathes.

In contrast, while patients with obesity and obstructive sleep apnea may have airway management challenges, their risk factors do not directly relate to the type of airway compromise indicated by stridor following extubation. Patients with blood pressure fluctuations may also experience a variety of complications, but stridor is specifically linked to airway mechanics and vocal cord function, which is primarily affected by RLN integrity. Thus, individuals with bilateral RLN damage present a clear pathway to developing stridor after the removal of an endotracheal tube.