Subglottic Stenosis Following Cardiac Surgery With Cardiopulmonary Bypass in Infants and Children.

OBJECTIVES

To determine the 1) incidence of subglottic stenosis in infants and children following cardiac surgery with cardiopulmonary bypass and 2) risk factors associated with its development.

DESIGN

Retrospective cohort study.

SETTING

Tertiary children's hospital in California.

PATIENTS: Infants and children who underwent cardiac surgery with cardiopulmonary bypass.

INTERVENTIONS: Diagnosis of subglottic stenosis by tracheoscopy.

MEASUREMENTS AND MAIN

RESULTS

The incidence of subglottic stenosis at our institution during the study period was 0.7%. Young age (p = 0.014), prolonged cardiopulmonary bypass (p = 0.03), and prolonged mechanical ventilation (p < 0.01) were associated with the development of subglottic stenosis. Gender, chromosomal anomaly, presence of a cuffed endotracheal tube, and lowest core temperature during cardiopulmonary bypass were not associated with the development of subglottic stenosis.

CONCLUSIONS

The incidence of subglottic stenosis was less than that previously reported in this population. Although the incidence is relatively low, subglottic stenosis is a serious complication of tracheal intubation and all measures to prevent subglottic stenosis should be undertaken.