Incidence and endoscopic characteristics of acute laryngeal lesions in children undergoing endotracheal intubation

• Autor(a) principal: Lima,Eliandra da Silveira de
• Data de Publicação: 2016
• Outros Autores: Oliveira,Maíra Alves Braga de, Barone,Carolina Rocha, Dias,Kharina Mayara Moreira, Rossi,Samanta Daiana de, Schweiger,Claudia, Manica,Denise, Enéas,Larissa Valency, Netto,Catia de Souza Saleh, Kuhl,Gabriel, Carvalho,Paulo Roberto Antonacci, Marostica,Paulo Jose Cauduro
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Brazilian Journal of Otorhinolaryngology
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1808-86942016000500507
• topic: Intubation; Laryngeal diseases; Laryngoscopy; Artificial respiration

ABSTRACT INTRODUCTION: Acute laryngeal lesions after intubation appear to be precursors of chronic lesions. OBJECTIVE: To describe the incidence and type of acute laryngeal lesions after extubation in a pediatric intensive care unit (PICU). METHODS: A cohort study involving children from birth to <5 years, submitted to intubation for more than 24 h in the PICU of an university hospital. In the first eight hours after extubation, a flexible fiberoptic laryngoscopy (FFL) was performed at the bedside. Those with moderate to severe abnormalities underwent a second examination seven to ten days later. RESULTS: 177 patients were included, with a median age of 2.46 months. The mean intubation time was 8.19 days. Seventy-three (41.2%) patients had moderate or severe alterations at the FFL, with the remaining showing only minor alterations or normal results. During follow-up, 16 children from the group with moderate to severe lesions developed subglottic stenosis. One patient from the normal FFL group had subglottic stenosis, resulting in an incidence of 9.6% of chronic lesions. CONCLUSION: Most children in the study developed mild acute laryngeal lesions caused by endotracheal intubation, which improved in a few days after extubation.