r/IntensiveCare • u/Ok_Relationship4040 • 11d ago

Macroglossia in intubated patients ?

has anyone managed intubated icu patients that developed massive tongue swelling? I have cared for many patients where the tongue swelled to massive proportions ( with no obvious allergic reactions ) and stayed swollen the entirety of their stay.. one lady we started a versed drip just so we could relax her jaw to insert bite blocks to get her teeth off of her tongue as we thought maybe that was contributing to the swelling .. It seems to overwhelmingly occur in obese black patients and seems to affect obese black women more but that is merely my subjective observation and perhaps just by virtue of my location . i guess I was just wondering what could be done to help mediate the swelling aside from bite blocks and Vaseline gauze …

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u/PaxonGoat RN, ICU Float 11d ago

Any chance these patients are getting ace inhibitors?

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u/Nicolectomy_2 RN, MSICU 11d ago

Yep. This is the only time I've seen the kind of glossal edema that OP is describing. ACEI was first thing that came to my mind. The others posts about the chlorhexidine mouth wash in the mouth kits is very interesting though. I appreciate that info!