EN
TÜRKÇE
Oral Presentation - 6
ASSOCIATION BETWEEN SUBGLOTTIC STENOSIS AND INTUBATION IN TRACHEOSTOMIZED PEDIATRIC PATIENTS
MM Urquizo Lino, J Camacho
Department of Pediatric Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
INTRODUCTION:
The Time of endotracheal intubation (TEI) is considered one of the main causes of acquired subglottic stenosis. Studies in the adult population suggest that performing a tracheostomy between days 10 and 15 after intubation could prevent laryngotracheal lesions
AIM:
To determine the timing for tracheostomy that would reduce stenosis´ incidence in pediatric patients.
MATERIAL AND METHODS:
A six-year period retrospective study including children and neonates who required a tracheostomy after endotracheal intubation was performed. Endoscopic findings at the time of tracheostomy were reviewed.
RESULTS:
189 patients underwent tracheostomy during the study period, 72 of which meet the inclusion criteria. The mean age was 40 months. The incidence of stenosis was 21%. The mean length of TEI before tracheostomy was 30 days and the mean age was 23 months. Airway stenosis was found as follows: Grade I 53.3% with TEI of 11 days, Grade II 33.3% with TEI of 20 days and Grade III 13.3% TEI of 56 days. Mean time to stenosis was 56 days in patients under six months of age, whereas in the older group, it was 24 days. Regarding 79% who did not present stenosis, 45% had other airway injuries at the time of video bronchoscopy and tracheostomy: ulcers, edema and granulomas. The mean duration of TEI was 20 days. Currently, 50% of patients have been decannulated.
DISCUSSION AND CONCLUSION:
Endotracheal tube permanence was directly associated with the occurrence and also the severity of airway stenosis in our population. In patients where endotracheal intubation is necessary, measures should be taken to avoid the development of laryngotracheal lesions, considering the performance of a tracheostomy in a preventive manner.