Association between subglottic stenosis and endotracheal intubation in tracheostomized pediatric patients.

Abstract

Objective: Considering that intubation time is the primary cause of subglottic stenosis, tracheostomy is suggested in adult patients following 10-15 days. The objective of this study was to analyze the association between intubation time and stenosis in pediatric patients, as well as to establish whether there is an adequate timing for tracheostomy in order to reduce the incidence of stenosis.

Materials and methods: A retrospective study (2014-2019) of tracheostomized newborns and children after an intubation period was carried out. Endoscopic findings at tracheostomy were analyzed.

Results: Tracheostomy was conducted in 189 patients, 72 of whom met inclusion criteria. Mean age was 40 months (1 month - 16 years). The incidence of stenosis was 21%, with a mean age of 23 months and a mean intubation time of 30 days vs. 19 days in the non-stenosis group (p= 0.02). The incidence of stenosis increased by 7% five days following intubation, reaching 20% after one month. Patients under 6 months old had greater tolerance to intubation periods without stenosis (incidence < 6% after 40 days, and median time to stenosis of 56 days vs. 24 days in patients over 6 months old).

Conclusions: In patients with long intubation periods, preventive measures should be taken in order to avoid laryngotracheal injuries, and early tracheostomy should be considered.