2023, Number 3
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Acta de Otorrinolaringología CCC 2023; 51 (3)
Prevalence of pediatric postintubation subglottic stenosis in a third level hospital in Colombia between 2017 and 2020
Hurtado-González M, Sánchez-Villegas E, Muñoz-Tamayo JF, Sierra-Jaramillo JA, Martínez-Soto D
Language: Spanish
References: 20
Page: 205-211
PDF size: 196.11 Kb.
ABSTRACT
Introduction: Pediatric orotracheal intubation has increased survival rates in severe
illnesses; however, one of the consequences maybe the development of subglottic
stenosis. This population is at a higher risk of developing it due to anatomical differences
compared to adults. The incidence of subglottic stenosis following orotracheal
intubation has decreased over time as reported in the literature. This study aimed to
assess the prevalence of this condition in our population and describe the clinical,
demographic, and diagnostic characteristics in the pediatric population diagnosed
with subglottic stenosis following orotracheal intubation at the San Vicente Fundación
Hospital. Additionally, it aimed to evaluate the prevalence of this diagnosis
during the mentioned period.
Materials and Methods: A retrospective study was
conducted by reviewing medical records of patients with ICD-10 codes for laryngeal
stenosis and for subglottic stenosis secondary to procedures. Also, the patients
with the procedure code for orotracheal intubation were identified. A descriptive
analysis was performed based on the distribution of variables.
Results: The prevalence
of subglottic stenosis was 13%. There was a majority of male cases, and the
primary cause of intubation was lower respiratory tract infection, mainly bronchiolitis.
The most frequent comorbidities included prematurity, swallowing disorders,
and broncho-obstructive syndrome. Median duration of intubation was 19 days, and
lower-grade stenosis was more commonly encountered.
Conclusions: Subglottic stenosis
is a complication of pediatric orotracheal intubation, with a prevalence of 13%
in this study. Patients who develop this condition require one or more procedures to
establish a patent airway and often experience prolonged hospital stays.
REFERENCES
Farias JA, Frutos F, Esteban A, Flores JC, Retta A, BaltodanoA, et al. What is the daily practice of mechanical ventilation inpediatric intensive care units? A multicenter study. IntensiveCare Med. 2004;30(5):918-25. doi: 10.1007/s00134-004-2225-5
Schweiger C, Manica D, Kuhl G, Sekine L, Marostica PJ.Post-intubation acute laryngeal injuries in infants and children:A new classification system. Int J Pediatr Otorhinolaryngol.2016;86:177-82. doi: 10.1016/j.ijporl.2016.04.032
Marshak G, Grundfast KM. Subglottic stenosis. PediatrClin North Am. 1981;28(4):941-8. doi: 10.1016/S0031-3955(16)34078-0
Monnier P. Pediatric Airway Surgery Management ofLaryngotracheal Stenosis in Infants and Children. Berlín:Springer-Verlag Berlin Heidelberg; 2011.
Jefferson ND, Cohen AP, Rutter MJ. Subglottic stenosis.Semin Pediatr Surg. 2016;25(3):138-43. doi: 10.1053/j.sempedsurg.2016.02.006
Schweiger C, Marostica PJ, Smith MM, Manica D, CarvalhoPR, Kuhl G. Incidence of post-intubation subglottic stenosis inchildren: prospective study. J Laryngol Otol. 2013;127(4):399-403. doi: 10.1017/S002221511300025X
Jorgensen J, Wei JL, Sykes KJ, Klem SA, Weatherly RA,Bruegger DE, et al. Incidence of and risk factors for airwaycomplications following endotracheal intubation forbronchiolitis. Otolaryngol Head Neck Surg. 2007;137(3):394-9. doi: 10.1016/j.otohns.2007.03.041
Lezcano López AI. Resultados del tratamiento de estenosissubglótica en niños en la Fundación Hospital de la Misericordiaentre los años 2009 a 2017 [Internet] [Tesis]. Bogotá:Universidad Nacional de Colombia; 2018 [citado el falta lafecha]. Disponible en: https://acortar.link/tem9yy
Schweiger C, Manica D, Pereira DRR, Carvalho PRA,Piva JP, Kuhl G, et al. Subsedação é um fato de risco parao desenvolvimento de estenose subglótica em criançasintubadas. J Pediatr (Rio J). 2017;93(4):351-5. doi: 10.1016/j.jped.2016.10.006
Lanari M, Prinelli F, Adorni F, Di Santo S, Vandini S, SilvestriM, et al. Risk factors for bronchiolitis hospitalization duringthe first year of life in a multicenter Italian birth cohort. Ital JPediatr. 2015;41:40. doi: 10.1186/s13052-015-0149-z
Nagayama Y, Tsubaki T, Nakayama S, Sawada K, TaguchiK, Tateno N, et al. Gender analysis in acute bronchiolitisdue to respiratory syncytial virus. Pediatr Allergy Immunol.2006;17(1):29-36. doi: 10.1111/j.1399-3038.2005.00339.x
Schweiger C, Eneas LV, Manica D, Netto CSS, Carvalho PRA,Piva JP, et al. Accuracy of stridor-based diagnosis of postintubationsubglottic stenosis in pediatric patients. J Pediatr (RioJ). 2020 Jan-Feb;96(1):39-45. doi: 10.1016/j.jped.2018.08.004
Cakir E, Atabek AA, Calim OF, Uzuner S, AlShadfan L, YazanH, et al. Post-intubation subglottic stenosis in children: Analysisof clinical features and risk factors. Pediatr Int. 2020;62(3):386-89. doi: 10.1111/ped.14122
Pinzas LA, Bedwell JR, Ongkasuwan J. Glottic and SubglotticInjury and Development of Pediatric Airway Stenosis.Otolaryngol Head Neck Surg. 2023;168(3):469-77. doi:10.1177/01945998221100829
Debs S, Kazi AA, Bastaich D, Thacker L, Petersson RS.Prognostic factors in the management of pediatric subglotticstenosis. Int J Pediatr Otorhinolaryngol. 2021;151:110931. doi:10.1016/j.ijporl.2021.110931
Lambercy K, Pincet L, Sandu K. Intubation Related LaryngealInjuries in Pediatric Population. Front Pediatr. 2021;9:594832.doi: 10.3389/fped.2021.594832
Sherman JM, Lowitt S, Stephenson C, Ironson G. Factorsinfluencing acquired subgottic stenosis in infants. J Pediatr.1986;109(2):322-7. doi: 10.1016/s0022-3476(86)80395-x
Manica D, Schweiger C, Maróstica PJ, Kuhl G, CarvalhoPR. Association between length of intubation and subglotticstenosis in children. Laryngoscope. 2013;123(4):1049-54. doi:10.1002/lary.23771
Marston AP, White DR. Subglottic Stenosis. Clin Perinatol.
2018;45(4):787-804. doi: 10.1016/j.clp.2018.07.01320. Arianpour K, Forman SN, Karabon P, Thottam PJ. Pediatricacquired subglottic stenosis: Associated costs and comorbiditiesof 7,981 hospitalizations. Int J Pediatr Otorhinolaryngol.2019;117:51-56. doi: 10.1016/j.ijporl.2018.11.016