Related Experiment Video

Updated: Feb 4, 2026

Guidelines for Elective Pediatric Fiberoptic Intubation
11:19

Guidelines for Elective Pediatric Fiberoptic Intubation

Published on: January 17, 2011

18.6K

Accuracy of stridor-based diagnosis of post-intubation subglottic stenosis in pediatric patients

Cláudia Schweiger1, Larissa Valency Eneas2, Denise Manica3

  • 1Hospital de Clínicas de Porto Alegre, Serviço de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil.

Jornal De Pediatria
|September 24, 2018
PubMed

Insights

Absence of stridor effectively rules out pediatric post-intubation subglottic stenosis. Stridor persisting over 72 hours improves diagnostic specificity for this condition.

Area of Science:

  • Pediatric critical care medicine
  • Otolaryngology
  • Respiratory diagnostics

Background:

  • Post-intubation subglottic stenosis is a significant complication in pediatric patients requiring prolonged mechanical ventilation.
  • Accurate and timely diagnosis is crucial for appropriate management and to prevent long-term respiratory sequelae.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of stridor as a clinical sign for identifying pediatric post-intubation subglottic stenosis.
  • To compare the effectiveness of stridor detection with endoscopic examination in this patient population.

Main Methods:

  • Prospective cohort study involving 187 children with endotracheal intubation exceeding 24 hours.
  • Daily monitoring for stridor post-extubation and flexible fiberoptic laryngoscopy.
  • Endoscopy under general anesthesia for persistent or severe cases.

Main Results:

  • The incidence of post-extubation stridor was 44.38%.
  • Stridor demonstrated a sensitivity of 77.78% and specificity of 59.18% for subglottic stenosis.
  • Absence of stridor had a high negative predictive value (96.15%), while stridor persisting >72h improved specificity to 89.1%.

Conclusions:

  • The absence of stridor is a reliable indicator to exclude post-intubation subglottic stenosis in children.
  • Stridor developing or persisting beyond 72 hours post-extubation warrants further endoscopic evaluation for subglottic stenosis.
Abstract

Keywords:
AccuracyAcquired subglottic stenosisEstenose subglótica adquiridaEstridorIntubationIntubaçãoLaringoscopiaLaryngoscopyPrecisãoStridor

More Related Videos

Surgical Management of Meatal Stenosis with Meatoplasty04:53

Surgical Management of Meatal Stenosis with Meatoplasty

Published on: November 30, 2010

54.8K
A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis09:36

A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis

Published on: August 12, 2025

684

Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
264
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
311
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
233
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
301
Improving Translational Accuracy02:07

Improving Translational Accuracy

Base complementarity between the three base pairs of mRNA codon and the tRNA anticodon is not a failsafe mechanism. Inaccuracies can range from a single mismatch to no correct base pairing at all. The free energy difference between the correct and nearly correct base pairs can be as small as 3 kcal/ mol. With complementarity being the only proofreading step, the estimated error frequency would be one wrong amino acid in every 100 amino acids incorporated. However, error frequencies observed in...
14.9K
Nursing Process for Patient and Caregiver Teaching I: Assessment and Diagnosis01:24

Nursing Process for Patient and Caregiver Teaching I: Assessment and Diagnosis

The nursing process provides a clinical decision-making framework for patients and families to establish and implement a personalized care plan. Since part of the nurse's duties is to teach patients, the steps of the nursing process are the most effective way to approach instruction. The nursing process and the teaching-learning process are inextricably linked.
It is critical to determine the patient's learning needs during the assessment. Determination of learning needs compounds data...
2.5K