Objectives: To determine the 1) incidence of subglottic stenosis in infants and children following cardiac surgery with cardiopulmonary bypass and 2) risk factors associated with its development.
Design: Retrospective cohort study.
Setting: Tertiary children's hospital in California.
Patients: Infants and children who underwent cardiac surgery with cardiopulmonary bypass.
Interventions: Diagnosis of subglottic stenosis by tracheoscopy.
Measurements And Main Results: The incidence of subglottic stenosis at our institution during the study period was 0.7%. Young age (p = 0.014), prolonged cardiopulmonary bypass (p = 0.03), and prolonged mechanical ventilation (p < 0.01) were associated with the development of subglottic stenosis. Gender, chromosomal anomaly, presence of a cuffed endotracheal tube, and lowest core temperature during cardiopulmonary bypass were not associated with the development of subglottic stenosis.
Conclusions: The incidence of subglottic stenosis was less than that previously reported in this population. Although the incidence is relatively low, subglottic stenosis is a serious complication of tracheal intubation and all measures to prevent subglottic stenosis should be undertaken.
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http://dx.doi.org/10.1097/PCC.0000000000001125 | DOI Listing |
Diagnostics (Basel)
December 2024
Department of Internal Medicine, Division of Rheumatology, Mayo Clinic, Jacksonville, FL 32224, USA.
Pulmonary involvement is commonly observed in anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), presenting with manifestations such as diffuse alveolar hemorrhage, inflammatory infiltrates, pulmonary nodules, and tracheobronchial disease. We aimed to identify distinct subgroups of tracheobronchial disease patterns in patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) using latent class analysis (LCA), and to evaluate their clinical characteristics and outcomes. We conducted a retrospective cohort study using electronic medical records of patients aged >18 years diagnosed with AAV and tracheobronchial disease between 1 January 2002 and 6 September 2022.
View Article and Find Full Text PDFInt J Pediatr Otorhinolaryngol
January 2025
Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Ann & Robert H Lurie Children's Hospital of Chicago, Division of Otolaryngology, Chicago, IL, USA.
Background: Cerebral palsy (CP) is the most common neuromuscular disorder in children, and children with CP are at increased risk of respiratory distress potentially requiring tracheostomy placement. Previous studies have characterized indications for tracheostomy in neurologically compromised children, however no studies focus specifically on children with CP. The purpose of this study was to identify the indications for tracheostomy placement, sites of airway obstruction, and rate of decannulation in children with CP.
View Article and Find Full Text PDFOtolaryngol Head Neck Surg
January 2025
Department of Otolaryngology-Head and Neck Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Objective: Determine if a flexed-neck posture during flexible nasolaryngoscopy (FNL) improves visualization of the subglottis.
Study Design: Retrospective review of children undergoing FNL in the neutral (FNL) and flexed-neck (FN-FNL) positions.
Setting: Tertiary children's hospital.
Subglottic stenosis after double-lumen tube (DLT) intubation is more likely to occur when an oversized DLT, specifically a 35 Fr DLT, is used in older, shorter women. Reintubation in such cases is challenging and may cause additional traumatic laryngitis. Tracheostomy is the best management for subglottic stenosis after DLT intubation.
View Article and Find Full Text PDFAnn Otol Rhinol Laryngol
January 2025
Department of Otolaryngology-Head and Neck Surgery, Pediatric Otolaryngology, Weill Cornell Medicine, New York, NY, USA.
Objective: To evaluate the effectiveness of coordinated endoscopy with otolaryngology, pulmonology, and gastroenterology in diagnosing and managing recurrent croup in pediatric patients.
Methods: We reviewed our REDCap Pediatric Aerodigestive Database for patients with recurrent croup who underwent coordinated endoscopy between January 2013 and July 2023. We reviewed patient demographics, comorbidities, surgical findings, treatments, and outcomes.
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