Do cuffed endotracheal tubes increase the risk of airway mucosal injury and post-extubation stridor in children?

Ashtekar, CS; Wardhaugh, A

doi:10.1136/adc.2005.077651

Cited by 24 publications

(18 citation statements)

References 7 publications

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“…These are also the main causes of respiratory distress in infancy, and are directly related with laryngotracheal stenosis. 9,13,14 According to Rocha et al, 15 when there is prolonged intubation, such as in children victims of cranial trauma, tracheotomy should be preferred to intubation, due to the lower risk of complications.…”

Section: Discussionmentioning

confidence: 99%

“…2,9,14 Respiratory distress with stridor in infancy is a dramatic situation that has a variety of causes. The medical assessment should include a first evaluation of respiratory involvement looking at the child's posture in the hospital bed, the presence of inspiratory and/or expiratory noises, nasal flapping, tachypnea, tachycardia, changes in the inspiratory and expiratory time ratio, cyanosis, pallor, sweating, chest indrawing, sleep loss and the feeding pattern.…”

Section: Discussionmentioning

confidence: 99%

“…Other causes of stridor in infancy include foreign body aspiration, vocal cord palsy, acute laryngitis, laryngocele, cysts and laryngeal papillomatosis. [8][9][10][11][12][13][14] Prompt medical attention is essential to establish the severity of cases with stridor and define the degree of respiratory distress. In most cases detailed airway endoscopy will be required not only for the diagnosis but also to treat the condition.…”

Section: Introductionmentioning

confidence: 99%

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Achados endoscópicos em crianças com estridor

Martins

Dias

Castilho

et al. 2006

Rev. Bras. Otorrinolaringol.

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Congeni tal and acquired airway diseases are responsible for upper respiratory distress and stridor in children. In neonatal intensive care units, we have seen increased survival in premature babies, but also a high incidence of airway complications related to intubation, which present as stridor. Aim: To review endoscopic findings in children with stridor. Study design: a cross-sectional cohort study. Methods: A retrospective analysis was done of 55 cases of children with stridor who underwent endoscopic exams, between January 1997 and December 2003. Results: 69% were aged below one year. The main indications for endoscopy were postextubation stridor (63.63%) and evaluation of neonatal stridor (21.82%). Many associated diseases were seen, including lung diseases (60%), neurological condition (45.4%), and GERD (40%). The main endoscopic findings and indications for tracheotomy were subglottic stenosis (27.27%) and airway inflammatory process (21.82%) occurring in children under five years old. Congenital disorders were more frequent in children under age one year. Conclusion: Neonatal stridor has many causes; those related to tracheal intubation are more frequent in hospitals that treat more complex diseases. Pediatricians and otorhinolaryngologists should know the main causes of stridor and perform detailed clinical evaluations to determine case severity. The endoscopic examination, must be meticulous.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Achados endoscópicos em crianças com estridor

Martins

Dias

Castilho

et al. 2006

Rev. Bras. Otorrinolaringol.

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show abstract

“…Por esta razón, no se recomendaba el uso de tubos con cuff en anestesia pediátrica para así evitar la lesión de la mucosa laríngea, manifestada por un espectro de complicaciones, desde estridor hasta secuelas más complejas 4,5,6 . El uso de cuff ofrece múltiples ventajas 7 como un mejor sello y protección de la vía aérea, menor necesidad de cambios de tubos, disminución de la contaminación ambiental por gases anestési-cos, medición más exacta del CO 2 espirado y de los parámetros ventilatorios.…”

Section: Introductionunclassified

“…The cuffed tracheal tubes effect on stridor risk, (adjusting for confounders), was non-significant: OR = 2,2; Conf. Interval 95% [0, [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]; p = 0,5. Conclusions: The use of cuffed endotracheal tubes did not increase the risk of post-extubation stridor in children.…”

Section: Introductionmentioning

confidence: 99%