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The Annals of otology, rhinology, and laryngology · 2024

Endoscopic Screening for Laryngotracheal Complications in Children Following Prolonged Mechanical Ventilation Maintained Through Endotracheal Intubation: A Cross-Sectional Pilot Project.

СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Dutta Mainak, Jana Debjit, Mukherjee Diptanshu, Panja Tanaya, Shukla Amit Kumar, Daga Divya, Yadav Krishna Kumar, Mondal Swarnali, Bandyopadhyay Saumendra Nath

Аннотация

BACKGROUND: An endoscopic screening program following successful weaning from prolonged mechanical ventilation maintained through endotracheal tube (ET; prolonged intubation) may be justified to assess the upper (laryngotracheal) airway in children who may not always be symptomatic for intubation-related complications.

OBJECTIVES: To evaluate effects of prolonged intubation in children through endoscopic screening of the laryngotracheal airway.

METHODS: In this cross-sectional pilot project, children (2 months-12 years) successfully extubated following prolonged intubation were selected, irrespective of having symptoms, for a 1-time flexible nasolaryngoscopy at third to sixth month post-extubation (follow-up window). Laryngotracheal airway changes, if present, were noted.

RESULTS: Out of 122 children, 42 developed symptoms of complications. Five of them attended within 3 months post-extubation, the rest were evaluated in the follow-up window. Eighty children aged ≤6 years and 4 children >6 years were intubated with uncuffed ET. Symptoms, when present, included respiratory distress (100%), noisy breathing (~36%), cough (~29%), and dysphagia (~12%). Screening revealed positive findings in 40 out of 42 symptomatic children, and in 8 out of 80 asymptomatic children (χ2 = 80.314; after Yate's correction; significant at P < .0001). The commonest lesion was subglottic stenosis (~54%) and intubation granuloma (~48%). Relationship between the nature of ET (cuffed/uncuffed) and complications of prolonged intubation was statistically significant (χ246.553; significant at P < .0001).

CONCLUSION: The present study proposes the potential utility of follow-up endoscopic screening of upper (laryngotracheal) airway in children successfully weaned from prolonged intubation. A statistically significant relationship existed between prolonged intubation and upper airway complications that were not always symptomatic.

Предметные рубрики MeSH

ИП Урсолов Владлен Сергеевич

ИНН 500118482352 · ОГРНИП 314500117700049

Реквизиты и контакты