Incidence and endoscopic characteristics of acute laryngeal lesions in children undergoing endotracheal intubation

Abstract

Most children in the study developed mild acute laryngeal lesions caused by endotracheal intubation, which improved in a few days after extubation.

“Post intubation Laryngeal injuries in a pediatric intensive care unit of tertiary hospital in India: A Fibreoptic endoscopic study”

“…However, it requires the patient to be exposed to general anesthesia, which may not be the best approach for a critically ill child who is recovering from a major illness De Lima et al, however, have preferred bedside examination with the help of flexible scope in awake patients. [14] Smith et al, in a study on 41 children in a PICU, noted that flexible laryngoscopy can be performed safely with a few minor complications. [15] They also concluded that laryngoscopy can be done easily with good visualization of all regions of the larynx, including subglottis.…”

Post‐intubation subglottic stenosis in children: Analysis of clinical features and risk factors

“…Subglottic stenosis is a complication that frequently develops after intubation and is characterized by respiratory distress . The aim of this study was to investigate the demographic features and risk factors associated with the development of SGS in intubated patients.…”

“…Subglottic stenosis (SGS) is one of the most common causes of upper airway obstruction in childhood. It can be congenital or acquired and has a frequency between 0.6% and 11% …”

“…Acquired SGS is a narrowing of the airway lumen at the subglottic area, which mostly develops secondary to intubation and can present with post‐extubation respiratory distress and stridor . Reviewing the literature, there are some studies that address follow‐up and surgical techniques in patients who have developed post‐intubation SGS.…”

Prevención, diagnóstico y manejo de lesiones laringotraqueales agudas y subagudas posintubación en pacientes pediátricos

“…Una laringoscopía inadecuada puede exponer el pecíolo epiglótico y promover el daño a nivel de la comisura anterior. En el caso del daño por presión, las zonas más afectadas son la cara medial de los aritenoides, la comisura posterior (debido a la ubicación del tubo en la laringe) 2 y la subglotis (pues es el punto más estrecho y menos distensible de la laringe pediátrica) 3 . La incidencia de lesiones isquémicas traqueales asociadas al cuff han disminuido considerablemente gracias al uso de balones de alto volumen y baja presión, que permitirían mantener un sello adecuado en la vía aérea sin superar la presión de perfusión capilar de la mucosa traqueal 4 .…”