Ulcerative tracheitis among intubated neonates--a clinicopathologic study

To determine frequency of ulcerative tracheitis (UT) among intubated neonates and identify groups of neonates at greater risk of UT.

Medical histories and autopsy findings from 232 neonates between 1995 and 2006 were reviewed retrospectively. All neonates were treated at the Department of Neonatology, Clinical Hospital Center Split. Autopsies and histological examinations were performed at the Clinical Department of Pathology, Forensic Medicine and Cytology. Neonates were classified into groups based on their sex, gestational age, survival time and cause of death, duration and reasons for intubation. Simplified Wigglesworth classification was used to determine cause of death. Chi-squared test and multiple logistical regression analysis were used for statistical analysis.

UT was found in 44 cases (18.96%). The main risk factor for UT development was duration of intubation, especially if it lasted over 96 h (P=0.005). Higher frequency of UT was noted in neonates with gestational age over 37 weeks (P=0.002) and birth weight over 2500 g (P=0.115).

Our study has shown that the main risk factor for UT development was intubation duration exceeding 96 h. Term-borns, and neonates with normal birth weight both have higher risk of UT. High risk groups should be observed carefully and alternative respiratory support treatment, such as continues positive airway pressure (CPAP) may be considered.