Post-extubation stridor after prolonged intubation in the pediatric intensive care unit (PICU): a prospective observational cohort study
| Autor: | M.P. van der Schroeff, Laura Veder, M.K. Timmerman, Koen F.M. Joosten, L.J. Hoeve, Bas Pullens, K Schlink |
|---|---|
| Přispěvatelé: | Otorhinolaryngology and Head and Neck Surgery, Pediatrics |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Complications Adolescent Prolonged intubation Stridor medicine.medical_treatment Subglottic stenosis Intensive Care Units Pediatric Laryngology 03 medical and health sciences 0302 clinical medicine otorhinolaryngologic diseases Intubation Intratracheal Humans Medicine Intubation Prospective Studies Laryngotracheal stenosis Child 030223 otorhinolaryngology Respiratory Sounds Pediatric intensive care unit Respiratory distress business.industry Infant Newborn Infant General Medicine Endotracheal tube medicine.disease Laryngeal damage 030228 respiratory system Otorhinolaryngology Child Preschool Emergency medicine Airway Extubation medicine.symptom business Pediatric airway Cohort study |
| Zdroj: | European Archives of Oto-Rhino-Laryngology, 277(6), 1725-1731. Springer-Verlag European Archives of Oto-Rhino-Laryngology |
| ISSN: | 0937-4477 |
| Popis: | Purpose Prolonged endotracheal intubation may lead to laryngeal damage, with stridor being the most relevant clinical symptom. Our objective was to determine the incidence of post-extubation stridor and their clinical consequences in children within a tertiary referral center and to identify contributing factors. Methods 150 children, aged 0–16 years, intubated for more than 24 h were prospectively enrolled until discharge of the hospital. Potential relevant factors, thought to mediate the risk of laryngeal damage, were recorded and analyzed. Results The median duration of intubation was 4 days, ranging from 1 to 31 days. Stridor following extubation occurred in 28 patients (18.7%); 3 of them required reintubation due to respiratory distress and in 1 child stridor persisted for which a surgical intervention was necessary. In multivariate analyses, we found the following independent predictors of stridor: intubation on the scene, the use of cuffed tubes and lower age. Conclusion Despite a high incidence for post-extubation stridor, only few children need reintubation or surgical intervention as a result of post-extubation lesions. Intubation on the scene, the use of cuffed tubes and young age are associated with a significant increased risk of post-extubation stridor. Awareness of these factors gives the possibility to anticipate on the situation and to minimize laryngeal injury and its possible future consequences. |
| Databáze: | OpenAIRE |
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