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Postintubation airway injury in the pediatric intensive care unit

Otilia E Blain1, Celeste C Patiño González1, Enrique J Romero Manteola1

  • 1Pediatric Surgery Department, Hospital de Niños de la Santísima Trinidad, Córdoba, Argentina.

Acta Otorrinolaringologica Espanola
|June 17, 2023
PubMed

Insights

Pediatric airway injury from endotracheal intubation (ETI) occurs in 3% of cases. Younger age and prolonged intubation are risk factors, with extubation failure and stridor indicating injury.

Area of Science:

  • Pediatric Intensive Care
  • Critical Care Medicine
  • Otolaryngology

Background:

  • Airway injury is a frequent complication of endotracheal intubation (ETI) in pediatric intensive care units (PICUs).
  • Understanding the incidence and predisposing factors for ETI-related airway injury is crucial for improving patient outcomes.

Purpose of the Study:

  • To determine the incidence and predisposing factors for airway injury in pediatric patients requiring ETI.
  • To evaluate indications for airway endoscopy and tracheostomy rates in this population.

Main Methods:

  • A retrospective, observational, descriptive study.
  • Evaluated 1854 patients intubated in a tertiary-care PICU from May 2015 to April 2019.

Main Results:

  • The incidence of ETI-related airway injury was 3%.
  • Younger age (<27 months) and prolonged intubation (>7 days) were significant predisposing factors.
  • Extubation failure and stridor were strongly associated with airway injury (p<0.001).

Conclusions:

  • The incidence of ETI-related airway injury in the PICU is 3%.
  • Early identification of risk factors like young age and prolonged intubation can aid in prevention.
  • Airway endoscopy is indicated for extubation failure and stridor, suggesting underlying injury.
Abstract

Keywords:
AirwayBronchoscopyEndontratracheal intubationEndotracheal intubationLaryngostenosisPediatrics

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