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Intubation complications in the critically ill child

N E Page1, M Giehl, S Luke

  • 1Department of Pediatrics, State University of New York Health Science Center, Syracuse University Hospital, USA.

AACN Clinical Issues
|March 20, 1998
PubMed
Summary

Pediatric intubation carries risks during the procedure, post-intubation, and with long-term endotracheal tube (ETT) use. Understanding and preventing these complications improves outcomes for critically ill children.

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Area of Science:

  • Pediatric Critical Care Medicine
  • Respiratory Therapy
  • Emergency Medicine

Background:

  • Children have unique anatomic and physiologic differences from adults, increasing risks during intubation and respiratory support.
  • Intubation in acutely ill children presents risks at multiple time points: during the procedure, in the immediate post-intubation period, and with prolonged endotracheal tube (ETT) use.
  • Effective management requires understanding the causes, assessment, prevention, and intervention strategies for potential complications.

Purpose of the Study:

  • To outline the critical considerations and potential complications associated with endotracheal intubation in pediatric patients.
  • To emphasize the importance of tailored approaches to pediatric airway management.
  • To highlight strategies for minimizing adverse events and improving patient outcomes.

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Main Methods:

  • Review of pediatric-specific intubation risks and complications.
  • Analysis of factors influencing airway management in children.
  • Discussion of ETT securement techniques and transport considerations.
  • Emphasis on preventative strategies and timely interventions.

Main Results:

  • Complications can arise during intubation, early post-intubation, and with long-term ETT placement.
  • Proper ETT securement is crucial for preventing displacement, airway trauma, and skin breakdown.
  • Intra- and interhospital transport require specific attention to maintain ETT placement and patient stability.

Conclusions:

  • Preventing intubation complications in children is essential for reducing hospital stay, healthcare costs, and family separation.
  • Proactive management can minimize long-term disabilities and prevent mortality in critically ill pediatric patients requiring intubation.
  • A comprehensive understanding of pediatric airway management is vital for optimizing care.