Iatrogenic tracheal rupture in children: A retrospective study

Schedlbauer, Eva-Maria; Todt, Ingo; Ernst, Arne; Seidl, Rainer

doi:10.1002/lary.20107

Cited by 23 publications

(12 citation statements)

References 18 publications

(15 reference statements)

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“…17,18 Endotracheal intubation is associated with discomfort to the patient and may result in malposition of the tube, trauma to the airway, and hemodynamic instability. 17,19–22 Endotracheal intubations have also been associated with alterations in brain function as monitored by electroencephalography. 23 …”

Section: Discussionmentioning

confidence: 99%

Markers of Successful Extubation in Extremely Preterm Infants, and Morbidity After Failed Extubation

Chawla

Natarajan

Shankaran

et al. 2017

The Journal of Pediatrics

112

104

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Objectives To identify variables associated with successful elective extubation, and to determine neonatal morbidities associated with extubation failure in extremely preterm neonates. Study design This study was a secondary analysis of the National Institute of Child Health and Human Development Neonatal Research Network’s Surfactant, Positive Pressure, and Oxygenation Randomized Trial that included extremely preterm infants born at 240/7 to 276/7 weeks’ gestation. Patients were randomized either to a permissive ventilatory strategy (continuous positive airway pressure group) or intubation followed by early surfactant (surfactant group). There were prespecified intubation and extubation criteria. Extubation failure was defined as reintubation within 5 days of extubation. Results Of 1316 infants in the trial, 1071 were eligible; 926 infants had data available on extubation status; 538 were successful and 388 failed extubation. The rate of successful extubation was 50% (188/374) in the continuous positive airway pressure group and 63% (350/552) in the surfactant group. Successful extubation was associated with higher 5-minute Apgar score, and pH prior to extubation, lower peak fraction of inspired oxygen within the first 24 hours of age and prior to extubation, lower partial pressure of carbon dioxide prior to extubation, and non-small for gestational age status after adjustment for the randomization group assignment. Infants who failed extubation had higher adjusted rates of mortality (OR 2.89), bronchopulmonary dysplasia (OR 3.06), and death/bronchopulmonary dysplasia (OR 3.27). Conclusions Higher 5-minute Apgar score, and pH prior to extubation, lower peak fraction of inspired oxygen within first 24 hours of age, lower partial pressure of carbon dioxide and fraction of inspired oxygen prior to extubation, and nonsmall for gestational age status were associated with successful extubation. Failed extubation was associated with significantly higher likelihood of mortality and morbidities. Trial registration ClinicalTrials.gov: NCT00233324.

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Section: Discussionmentioning

confidence: 99%

Markers of Successful Extubation in Extremely Preterm Infants, and Morbidity After Failed Extubation

Chawla

Natarajan

Shankaran

et al. 2017

The Journal of Pediatrics

112

104

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“…1, 6 Our own experience of tracheal injuries confirms this finding. 14 Furthermore, an appropriate cuff size is required for sufficient ventilation. Despite the large number of intubations performed every day, no evidence‐based guidelines on tube selection and placement are available.…”

Section: Discussionmentioning

confidence: 99%

Selection and placement of oral ventilation tubes based on tracheal morphometry

et al. 2011

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“…Schedlbauer et al [15] reported 18 cases of tracheal injuries in a review from 2000 to 2007 at a level I trauma center. Only four cases were found in pediatric patients, none of which were in neonates.…”

Section: Tracheal Rupture Secondary To Endotracheal Intubationmentioning

confidence: 98%