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Histopathologic changes in laryngeal mucosa of extremely low-birth weight infants after endotracheal intubation

Kiminori Sato1, Tadashi Nakashima

  • 1Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan.

The Annals of Otology, Rhinology, and Laryngology
|December 15, 2006
PubMed

Insights

Infants, including extremely low-birth weight infants, experience laryngeal injury from endotracheal intubation. Histopathology shows injury and healing occur, with severity related to intubation duration, not birth weight.

Area of Science:

  • Pediatric Medicine
  • Otolaryngology
  • Neonatology

Background:

  • Medical advancements have increased survival rates for premature infants.
  • Laryngeal injury from endotracheal intubation is a concern in neonates.
  • Histopathologic data on intubation injury in extremely low-birth weight infants is limited.

Purpose of the Study:

  • To investigate the histopathologic changes in infant larynges following endotracheal intubation.
  • To specifically examine these changes in extremely low-birth weight infants.

Main Methods:

  • A whole organ serial section study was conducted on 44 infants.
  • Infants included 21 extremely low-birth weight infants (less than 1,000 g).
  • Intubation durations ranged from 10 minutes to 138 days.

Main Results:

  • Increased intubation duration correlated with larger and deeper laryngeal ulcerations.
  • Subglottic and posterior glottic regions showed the most significant injury.
  • Evidence of epithelial repair (squamous epithelium) was observed in prolonged intubations (>20 days).
  • No clear relationship was found between injury severity and infant birth weight.

Conclusions:

  • Infants tolerate prolonged intubation better than adults.
  • Histopathologic laryngeal injuries from intubation are similar across different infant birth weights.
  • Both injury and healing processes occur during prolonged endotracheal intubation in infants.
Abstract

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