Prolonged Intubation of Neonates

Dankle, Steven K.; Schuller, David E.; McClead, Richard E.

doi:10.1001/archotol.1987.01860080047014

Cited by 32 publications

(28 citation statements)

References 18 publications

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“…Concomitantly, there have been significant changes in the management of the neonatal airway [4]. Fewer neonates are now requiring tracheostomy, with rates decreasing from 2.7% in 1978 to 0.55% in 2001 [1,5,6]. The indication for a tracheostomy in a neonate has shifted from upper airway obstruction to prolonged intubation and failed extubation [2,7,8].…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, neonatal airway management has shown a trend toward fewer days of intubation and ventilation. Prolonged intubation has been associated with airway damage, including laryngeal edema, granulation tissue formation, vocal cord paralysis, subglottic stenosis and tracheal stenosis [1]. At times a tracheostomy is required in the preterm infant for prolonged ventilatory support or upper airway obstruction.…”

Section: Introductionmentioning

confidence: 99%

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Failed extubation in the neonatal intensive care unit

Pereira¹,

Smith²,

Henry³

2007

International Journal of Pediatric Otorhinolaryngology

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Failed extubation in the neonatal intensive care unit

Pereira¹,

Smith²,

Henry³

2007

International Journal of Pediatric Otorhinolaryngology

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“…SGS is a serious long-term complication of endotracheal intubation in the neonate, with previous reported incidences of SGS ranging from 1 to 13% [3,6,10,13,18,19]. Although the incidence of airway injury is felt to be decreasing in today's modern neonatal intensive care units (NICUs) with meticulous management of the airways of VLBW infants, some centres still report a high frequency of complications, including SGS and tracheomalacia [19].…”

Section: Introductionmentioning

confidence: 99%

Complications of Airway Management in Very-Low-Birth-Weight Infants

Silva¹,

Stevens²

1998

Neonatology

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Objective: To define the incidence of complications of endotracheal intubation and the factors associated with these complications. Study Design: During a 22-month period, 227 intubated infants weighing <1,501 g were followed prospectively in a neonatal intensive care unit. Detailed records of events associated with airway management were kept after every intubation, in addition to clinical data. Results: Eleven infants (4.8%) developed respiratory stridor after extubation which was treated with either systemic corticosteroids, racemic epinephrine and/or reintubation for respiratory failure. Four infants were submitted for bronchoscopy, mild subglottic stenosis with tracheal edema was found in 1 patient, granulation tissue and airway edema were noted in 3 infants. Traumatic intubation, prolonged ventilation, multiple intubations and bacterial colonization of the endotracheal tube were the factors associated with postextubation stridor. Conclusions: Subglottic stenosis is an infrequent complication of endotracheal intubation with current airway management of very-low-birth-weight infants. Less severe complications are still common, but they are usually amenable to clinical treatment. Bronchoscopy should be performed selectively only in infants with clinical evidence of airway obstruction after extubation.

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“…The number of days of oxygen use and the postnatal age (weeks) at which nipple feeding was begun were the most powerful predictors of sucking ability at term (P<.001), whereas the number of days of orotracheal intubation and gestational age at birth were the most powerful predictors of sucking ability at 3 months (P<.001). In addition, several studies showed significant palatal groove formation in infants who undergo for more than 1 week.1"7 We hypothe¬ sized that medical complications of prolonged (more than 1 week) would have a negative effect on an infant's ability to suck successfully (ie, demonstrate a normal sucking pattern) at term and at 3 months' corrected age. 1993;147:858-862) Although the medical and histological complications of orotracheal intubation ( ) have been described,1"12 the developmental complications have not.…”

mentioning

confidence: 99%