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Incidence of post-intubation subglottic stenosis in children: prospective study

Published online by Cambridge University Press:  28 February 2013

C Schweiger ,
P J Cauduro Marostica ,
M M Smith ,
D Manica ,
P R Antonacci Carvalho  and
G Kuhl
C Schweiger*
Affiliation:
Department of Otolaryngology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
P J Cauduro Marostica
Affiliation:
Department of Paediatric Emergency, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Paediatric Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
M M Smith
Affiliation:
Department of Otolaryngology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
D Manica
Affiliation:
Department of Otolaryngology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
P R Antonacci Carvalho
Affiliation:
Paediatric Intensive Care Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil Paediatric Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
G Kuhl
Affiliation:
Department of Otolaryngology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
*
Address for correspondence: Dr Claudia Schweiger, Ramiro Barcelos, 2350 Zona 19, 90035-903, Porto Alegre, RS, Brazil Fax: + 55 51 3359 8001 E-mail: [email protected]
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Abstract

Objective:

To evaluate the incidence of subglottic stenosis in children undergoing endotracheal intubation.

Methods:

Children in the paediatric intensive care unit of a tertiary care hospital were considered eligible for inclusion if they received endotracheal intubation for more than 24 hours. After extubation, children underwent flexible fibre-optic nasolaryngoscopy. Based on this first evaluation, they were divided into two groups: ‘acute normal’, with mild laryngeal alterations or normal findings; and ‘acute alterations’, with moderate to severe laryngeal alterations. Further laryngoscopic follow up (7–10 days later) was undertaken for those children in the acute normal group who developed symptoms during follow up (after discharge from the intensive care unit), and for all children in the acute alterations group. Children were then classified into two final groups: ‘normal final examination’, with no chronic changes; and ‘subglottic stenosis’.

Results:

We included 123 children. The incidence of subglottic stenosis was 11.38 per cent (95 per cent confidence interval, 6.63–17.94 per cent). All the children who developed subglottic stenosis had had moderate to severe alterations immediately after extubation.

Conclusion:

This incidence of subglottic stenosis is quite high and needs further investigation to identify risk factors.

Keywords

ChildAcquired Subglottic StenosisPrevalenceDiagnosis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 4 , April 2013 , pp. 399 - 403
Copyright
Copyright © JLO (1984) Limited 2013

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