African journal of thoracic and critical care medicine · 2026
Acquired subglottic stenosis in children younger than 1 year in a resource-restricted hospital in South Africa.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Kemp T, Goussard P, van Wyk L, Merven M
Аннотация
BACKGROUND: Subglottic stenosis (SGS) is a congenital or acquired condition and is the most common site of airway narrowing in children. The pathogenesis of SGS includes subglottic mucosal pressure necrosis, leading to mucosal ulceration, perichondritis and mature scar formation. Acquired SGS accounts for 90% of laryngotracheal stenosis in children.
OBJECTIVES: To describe the associated disease factors, management and outcomes of infants with acquired SGS in a middle-income country.
METHODS: A retrospective, descriptive study was performed between January 2018 and August 2022, including all infants aged ≤1 year who had bronchoscopically confirmed SGS. Data regarding demographics, intubation and invasive ventilation, various disease parameters, findings at bronchoscopy and short-term outcomes were collected. Descriptive statistical analysis was performed. Ethical approval was provided by Stellenbosch University.
RESULTS: During the research period, 44 infants were diagnosed with acquired SGS, of whom 29 were included in the study. Most infants were born at term and underwent diagnostic bronchoscopy at a mean chronological age of <2 months. All infants were intubated and ventilated at birth, for a variety of diagnoses. Bronchoscopy showed grade 2 or worse stenosis in the majority, and most infants were managed successfully with balloon dilatation. An inappropriately sized endotracheal tube was used in 52% of infants, one-third of infants required multiple invasive ventilation periods, and one-third experienced unexpected extubation episodes.
CONCLUSION: In a resource-limited setting, SGS often develops as a result of preventable causes, with the majority of children being successfully treated with endoscopic procedures.
STUDY SYNOPSIS: What the study adds. The characteristics and management of subglottic stenosis (SGS) in infants aged ≤1 year are described in this retrospective study done at Tygerberg Hospital, South Africa. This is the first report of acquired SGS in infants aged ≤1 year from a resource limited setting. Potential preventable risk factors were identified, specifically looking at the tertiary referral setting. The most common factor was use of an endotracheal tube (ETT) of the incorrect size. A few possible novel associations were also identified, that require further investigation. Balloon dilatation was noted to be an effective treatment option, and is feasible for use in resource-limited settings.Implications of the findings. The findings of this study highlight the importance of having correct intubation practices in place to reduce the risk of acquired SGS. Training, supervision and correct documentation of airway management will contribute to a reduction in intubation attempts and unplanned extubations, and improve knowledge on the correct size of ETT to be used. The findings also support the effectiveness of balloon dilatation as a treatment option in a resource-limited setting.
OBJECTIVES: To describe the associated disease factors, management and outcomes of infants with acquired SGS in a middle-income country.
METHODS: A retrospective, descriptive study was performed between January 2018 and August 2022, including all infants aged ≤1 year who had bronchoscopically confirmed SGS. Data regarding demographics, intubation and invasive ventilation, various disease parameters, findings at bronchoscopy and short-term outcomes were collected. Descriptive statistical analysis was performed. Ethical approval was provided by Stellenbosch University.
RESULTS: During the research period, 44 infants were diagnosed with acquired SGS, of whom 29 were included in the study. Most infants were born at term and underwent diagnostic bronchoscopy at a mean chronological age of <2 months. All infants were intubated and ventilated at birth, for a variety of diagnoses. Bronchoscopy showed grade 2 or worse stenosis in the majority, and most infants were managed successfully with balloon dilatation. An inappropriately sized endotracheal tube was used in 52% of infants, one-third of infants required multiple invasive ventilation periods, and one-third experienced unexpected extubation episodes.
CONCLUSION: In a resource-limited setting, SGS often develops as a result of preventable causes, with the majority of children being successfully treated with endoscopic procedures.
STUDY SYNOPSIS: What the study adds. The characteristics and management of subglottic stenosis (SGS) in infants aged ≤1 year are described in this retrospective study done at Tygerberg Hospital, South Africa. This is the first report of acquired SGS in infants aged ≤1 year from a resource limited setting. Potential preventable risk factors were identified, specifically looking at the tertiary referral setting. The most common factor was use of an endotracheal tube (ETT) of the incorrect size. A few possible novel associations were also identified, that require further investigation. Balloon dilatation was noted to be an effective treatment option, and is feasible for use in resource-limited settings.Implications of the findings. The findings of this study highlight the importance of having correct intubation practices in place to reduce the risk of acquired SGS. Training, supervision and correct documentation of airway management will contribute to a reduction in intubation attempts and unplanned extubations, and improve knowledge on the correct size of ETT to be used. The findings also support the effectiveness of balloon dilatation as a treatment option in a resource-limited setting.