Analysis of early post intubation lesions in larynx after prolonged intubation in children

*Lidia Zawadzka-Głos, Krzysztof Ślączka

Summary
Introduction. Respiratory failure followed by endotracheal intubation can lead to severe post intubation laryngeal lesions in small group of patients. Complikations are classified as acute (early) and chronic on a base the laryngoscopy findings.
Aim. To assess the statistical relationship between early post intubation complications and intubation duration, birth weight and gestational age.
Material and methods. The study included 65 children threated in Pediatric Otolaryngology Department presented with early post intubation complication such as subglottic edema, subglottic ulceration, granulation and non-specific lesions. The study was based on the medical records taken during direct laryngoscopy procedure as well as on the demographic factors, such as birth weight and gestational age. Additional factor included into the study was duration of intubation.
Results. Most of the acute lesions of intubated larynx depend on trauma of mucous membrane. Disfunction of mucosal blood supply during intubation leads to inflammation, edema, infection, ulceration, necrosis or destruction of laryngeal cartilages. Not only the local risk factors matter but also the demographic factors are important. Endoscopy of larynx makes it possible to determine the progression of lesions. Our study revealed, that early post intubation complications such as edema were more likely to affect children with advanced gestational age or higher birth weight. Moreover, the subglottic edema appeared in the group of children with considerably shorter intubation duration. However, the subglottic ulcerations in children are significantly correlated with lower birth weight.
Conclusion. early post intubation lesions, such as edema and subglottic ulcerations are clinically important. Early post intubation lesions strongly depend on the intubation duration, prematurity and low birth weight.

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