Predictive Factors for Complications in Children With Laryngeal Damage at Extubation

Watier-Launey, C; Buronfosse, A.; Saliba, Élie; Bertrand, P.; Ployet, M. J.

doi:10.1097/00005537-200002010-00029

Cited by 9 publications

(1 citation statement)

References 12 publications

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“…Patients with higher ASA classes have co‐morbidities and often prolonged postoperative intubation periods, which may explain these findings. Whether prolonged intubation is a risk factor for laryngeal damage is still undetermined . Larger populations are required to define its impact on airway pathologies.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic airway findings in children with or without prior endotracheal intubation

Weiß

Bailey

Gysin

et al. 2013

Pediatric Anesthesia

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SummaryBackground: Airway alterations found after endotracheal intubation are usually associated with mechanical trauma from the tube. However, no studies are available concerning alterations in airways that have never been intubated before. It was the aim of the study to compare endoscopic findings in the larynx and trachea of children who had undergone prior endotracheal intubation with findings in children who had not been intubated before. Methods: In 1021 children aged from 0 to 6 years, rigid endoscopies were performed before planned elective endotracheal intubation. The anonymized endoscopy videos were reviewed and graded by five international airway experts. Data was compared between the two groups using the chi-square test (P 0.05). Results: Endoscopic records of 971 children (473 with prior intubation; 498 without prior airway intubation) were included in the final calculations. Most patients (93.7%) with prior intubation had been intubated with a cuffed tube. The number of intubations ranged from 1 to 27. The median interval between intubation and endoscopy was 0.53 years (0.003-5.57 years). Abnormal findings were observed in 31.7% and 26.8% of patients with and without prior intubation, respectively (P = 0.063). Glottic granulomas were significantly more common after intubation (3.6% vs 1.4%; P = 0.028). The incidence of other abnormal findings was similar in both groups. Conclusion: Endoscopic airway alterations can be observed in about onequarter of children presenting for routine surgery without prior intubation. Except for glottic granulomas, the abnormalities are found with similar frequency in patients with and without prior intubation. No relevant airway damage from short-term endotracheal intubation was found.

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Section: Discussionmentioning

confidence: 99%

Endoscopic airway findings in children with or without prior endotracheal intubation

Weiß

Bailey

Gysin

et al. 2013

Pediatric Anesthesia

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Die Wahl des endotrachealen Tubus beim Säugling und Kleinkind: Mit oder ohne Cuff?

Erb

Frei

2001

Der Anaesthesist

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The use of endotracheal tubes with a cuff is controversial in infants and small children. Often anaesthetists advocate extreme opinions and whereas some propagate the use of cuffed tubes in all cases without restriction, others condemn their use in infants and small children under all circumstances. In this article, the discussion concerning the use of cuffed endotracheal tubes in infants and small children is based on current data and arguments. Relevant facts about the anatomy of the upper airway are reviewed and tube products that are currently available, their correct use in infants as well as the inherent potential advantages and disadvantages related to their use are discussed. The overall incidence of iatrogenic damage after short lasting endotracheal intubation is low. However, acquired subglottic stenosis might represent a severe long-lasting complication. Regardless as to whether tubes with or without cuffs are used, a disproportion between the outer diameter of the tube and the inner diameter of the nonexpandable cricoid ring is the main reason for the genesis of this lesion. A continuous monitoring of the cuff pressure is recommended when using cuffed endotracheal tubes in this age group.

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Frequency and Indications for Tracheostomy and Gastrostomy After Congenital Heart Surgery

et al. 2008

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Patients undergoing congenital heart surgery may occasionally require additional surgical procedures in the form of tracheostomy and gastrostomy. These procedures are often performed in an attempt to diminish hospital morbidity and length of stay. We reviewed the Web-based medical records of all patients undergoing congenital heart surgery at Miami Children's Hospital from February 2002 through August 2007. Patients who were deemed preterm and had undergone closure of a patent ductus arteriosis were eliminated. The records of all other patients were queried for the terms gastrostomy, g-tube, Nissan, fundal plication, tracheostomy, or tracheotomy. Patients' medical records in which these terms appeared in any portion were completely reviewed. There were 1660 congenital heart operations performed in the study period. There were 592 operations performed on patients whose age ranged from 1 month to 1 year and 441 neonatal operations. Mortality was 2%. Median postoperative stay was 8 days (range, 1-191 days), 12 days for neonates (range, 3-142 days), and 19 days for neonates undergoing RACHS-1 category 6 operations (range, 4-142 days). Tracheostomies were performed in four patients (0.2%). Gastrostomies were performed on eight patients (0.4%), representing 0.8% of patients <1 year of age, 1.4% of neonates, and 2.4% of patients undergoing RACHS-1 category 6 operations. The rate of patients undergoing either tracheostomy or gastrostomy after congenital heart surgery at our institution was quite low. Avoidance of either of these two procedures was achieved without increased morbidity or length of stay. The rate at which these procedures need to be performed may reflect the magnitude of the patients' lifetime trauma related to their underlying condition and acute and total surgical experiences.

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Predictive Factors for Complications in Children With Laryngeal Damage at Extubation

Cited by 9 publications

References 12 publications

Endoscopic airway findings in children with or without prior endotracheal intubation

Endoscopic airway findings in children with or without prior endotracheal intubation

Die Wahl des endotrachealen Tubus beim Säugling und Kleinkind: Mit oder ohne Cuff?

Frequency and Indications for Tracheostomy and Gastrostomy After Congenital Heart Surgery

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