AI Article Synopsis
- The study aimed to analyze how the duration of intubation and other risk factors contribute to laryngeal lesions in children, specifically focusing on subglottic stenosis (SGS).
- A prospective approach was taken, examining 142 children under 5 years old who were intubated for over 24 hours, assessing laryngeal condition through flexible fiber-optic laryngoscopy.
- Results showed that 40.8% of children had significant laryngeal issues initially, with an SGS incidence of 11.3%, indicating that longer intubation and more sedative doses substantially increase the risk of SGS.
Article Abstract
Objectives/hypothesis: To investigate the role of the length of intubation and other risk factors in the development of laryngeal lesions in children undergoing endotracheal intubation in an intensive care unit and to determine the incidence of subglottic stenosis (SGS).
Study Design: Prospective study.
Methods: Children aged from birth to <5 years admitted to the Pediatric Intensive Care Unit of Hospital de Clinicas de Porto Alegre who required endotracheal intubation for more than 24 hours were eligible. Children underwent flexible fiber-optic laryngoscopy (FFL) after extubation. Those who presented moderate to severe abnormalities in this first examination underwent another FFL between 7 and 10 days. If lesions persisted or symptoms developed, regardless of initial findings, laryngoscopy under general anesthesia was performed.
Results: We followed 142 children. In the first FFL, 58 children (40.8%) had moderate to severe laryngeal lesions. During follow-up, 16 children developed SGS, representing an incidence of 11.3% (95% confidence interval, 7.1-17.5). Multivariate analysis showed that for every 5 additional days of intubation, there was a 50.3% increase in the risk of developing SGS, and for each additional sedation doses/day, there was a 12% increase in the same outcome.
Conclusions: In this first prospective research protocol in children, we found a higher incidence of SGS than in most previous studies. The length of intubation and the need for additional sedation doses appear to be key factors for the development of SGS during endotracheal intubation.
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| http://dx.doi.org/10.1002/lary.23771 | DOI Listing |
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