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Complications of airway management in very-low-birth-weight infants

O da Silva1, D Stevens

  • 1Department of Pediatrics, St. Joseph's Health Centre, University of Western Ontario, London, Ont., Canada. odasilva@julian.uwo.ca

Biology of the Neonate
|November 30, 1998
PubMed

Insights

Endotracheal intubation complications in very-low-birth-weight infants are infrequent, with subglottic stenosis being rare. Less severe airway issues are common but treatable, guiding selective bronchoscopy use.

Area of Science:

  • Neonatal intensive care
  • Pediatric airway management
  • Critical care medicine

Background:

  • Endotracheal intubation is a common procedure in neonatal intensive care units.
  • Complications can arise from intubation, impacting infant outcomes.
  • Understanding incidence and risk factors is crucial for improving patient care.

Purpose of the Study:

  • To determine the incidence of endotracheal intubation complications in very-low-birth-weight infants.
  • To identify factors associated with these complications.

Main Methods:

  • Prospective follow-up of 227 intubated infants (<1,501 g) over 22 months.
  • Detailed recording of airway management events and clinical data.
  • Analysis of factors linked to postextubation stridor.

Main Results:

  • 4.8% of infants developed postextubation respiratory stridor.
  • Factors associated with stridor included traumatic intubation, prolonged ventilation, multiple intubations, and bacterial colonization.
  • Mild subglottic stenosis was found in one infant; airway edema and granulation tissue in three.

Conclusions:

  • Subglottic stenosis is an infrequent complication in this population with current management.
  • Less severe airway complications are common but clinically manageable.
  • Bronchoscopy is recommended selectively for infants with airway obstruction evidence postextubation.
Abstract

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