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Updated: Oct 7, 2025
Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Post-intubation tracheal stenosis in pediatric age group: single-center experiences of 24 years
Mojtaba Mokhber Dezfuli1, Seyed Reza Saghebi2, Mohammad Behgam Shadmehr3
1Lung Transplantation Research Center (LTRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Insights
Post-intubation tracheal stenosis (PITS) is a serious complication in children. This study found trauma as the leading cause and varying surgical success rates, emphasizing PITS in differential diagnoses for pediatric dyspnea.
Area of Science:
- Pediatric Pulmonology
- Otolaryngology
- Critical Care Medicine
Background:
- Post-intubation tracheal stenosis (PITS) is an iatrogenic complication affecting pediatric patients.
- Masih Daneshvari Hospital in Tehran, Iran, receives a significant number of children with tracheal stenosis.
Purpose of the Study:
- To investigate the characteristics and outcomes of tracheal stenosis following prolonged intubation in the pediatric age group.
- To analyze demographic data, clinical presentation, causes, and treatment approaches for pediatric PITS.
Main Methods:
- Observational retrospective study of children under 14 years with PITS from 1994 to 2018.
- Review of medical records for demographic and clinical data, including intubation details, stenosis type, and surgical outcomes.
- Statistical analysis using SPSS.
Main Results:
- 161 pediatric patients (69% male, mean age 9.8 years) were analyzed.
- Tracheal stenosis alone occurred in 47%; trauma was the most common intubation cause.
- Surgical success rates varied by stenosis type (Type I: 93.75%, Type II: 82.15%, Type III: 35.70%); mortality rate was 8.7%.
Conclusions:
- Post-intubation tracheal stenosis (PITS) must be considered in the differential diagnosis of pediatric dyspnea.
- The study highlights the importance of recognizing and managing PITS in children.
Background And Aim:
Post-intubation tracheal stenosis (PITS) is an iatrogenic injury that involves some patients. Given the importance of this issue and the referral of a significant number of children with tracheal stenosis to Masih Daneshvari Hospital in Tehran, Iran, the present study investigated tracheal stenosis following prolonged intubation in the pediatric age group.
Methods:
In this observational retrospective study, from 1994 to 2018, the medical records of all children under 14 years of age with a history of PITS were reviewed. Demographic and clinical characteristics including signs and symptoms, the underlying condition that leads to intubation, duration of intubation, type of stenosis, and the therapeutic approach, type of surgery, and follow-up were collected and analyzed using SPSS.
Results:
Among 161 patients with a mean age of 9.8 ± 4.2 years, 69% were male. The site of stenosis was limited to the trachea in 47% and others both trachea and subglottic area were involved. The most common cause of intubation was trauma. The most common symptoms were dyspnea and wheezing. Success rates of reconstruction were 93.75% in type I, 82.15% in type II, and 35.70% in type III. Among the 16 patients who underwent Type III surgery, decannulation was not performed in 11 patients. Traction in the anastomosis and complications were stated in 26 and 10% of the patients respectively, a mortality rate of 8.7% was also reported.
Conclusion:
In the case of endotracheal intubation, PITS should be considered in the differential diagnosis of dyspnea in children as well as adults.
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