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Review of intubation in severe laryngotracheobronchitis

J McEniery1, J Gillis, H Kilham

  • 1Intensive Care Unit, Children's Hospital, Camperdown, Sydney, Australia.

Pediatrics
|June 1, 1991
PubMed

Insights

Nasotracheal intubation is a safe airway for treating severe laryngotracheobronchitis in children. Selective endoscopy and tracheostomy help prevent long-term airway complications.

Area of Science:

  • Pediatric Otolaryngology
  • Critical Care Medicine
  • Respiratory Medicine

Background:

  • Severe laryngotracheobronchitis frequently necessitates artificial airway management.
  • Artificial airways, including nasotracheal intubation and tracheostomy, are critical interventions.

Purpose of the Study:

  • To evaluate the safety and efficacy of nasotracheal intubation versus tracheostomy for severe laryngotracheobronchitis.
  • To assess the incidence of complications, particularly acquired subglottic stenosis.

Main Methods:

  • Retrospective review of 208 children requiring artificial airways for laryngotracheobronchitis over 10 years.
  • Analysis of intubation duration, need for tracheostomy, and long-term outcomes.

Main Results:

  • 181 children (87%) were successfully intubated and extubated; 27 (13%) required tracheostomy.
  • Tracheostomies were primarily for subglottic narrowing or endotracheal tube trauma.
  • Acquired subglottic stenosis occurred in 5 children (2.4%), with one retaining a tracheostomy.

Conclusions:

  • Nasotracheal intubation is a satisfactory airway for laryngotracheobronchitis.
  • Selective endoscopic evaluation identifies children at risk for subglottic damage.
  • Low stenosis rates support selective endoscopy and tracheostomy practices.

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