[Incidence and endoscopic characteristics of airway injuries associated endotracheal intubation in children].
OBJECTIVE
Describe the incidence and endoscopic characteristics of airway injuries in children submitted to intubation.


METHODS
During a two-year period (October/1999-October/2001) we conducted a prospective study in which all patients that required intubation, excluding those who deceased before extubation and newborns (NB) weighing less than 1.250 g, were submitted to airway endoscopy at extubation. The endoscopic findings were classified as minor, moderate or severe. Descriptions were made through proportions and medians, comparisons were done through chi-square for proportions.


RESULTS
We studied 61 NB and 154 children. In 89.8%, 55 NB and 138 children (P=0.89), it was detected at least one lesion in a total of 507. Patients with minor lesions were 54.8% (IC95%: 48.1-61.5), those with moderate were 24.2% (IC95%: 18.5-30.0) and severe injury occurred in 10.7% (IC95%: 6.6-14.8). Lesions at the glottis (48.1% of lesions) and subglottis (35.1%) presented the highest incidence. Erosions had the highest incidence in both age groups (P=0.88). Vocal folds edema was the main moderate lesion in both groups (P=0.96), followed by ulcerations (P=0.92). Fibrous nodules at vocal folds and adhesions were the main severe injuries in both groups (P=0.12). Subglottic stenosis was detected in 2.8% of the patients without difference between groups (P=0.35).


CONCLUSIONS
We observed a high incidence of airway injury, without statistical significant difference between age groups in regard to the incidence and characteristics of the injuries. Minor injury was detected in the majority of the population. Lesions were mainly noticed at the glottis and were characterized by erosions, edema and ulcerations.
Cordeiro
Andréa Maria Gomes
AM
Unidade de Terapia Intensiva Pediátrica do Hospital Universitário da USP, São Paulo, SP.
Shin
Shieh Huei
SH
Fernandes
Iracema de Cássia Oliveira Ferreira
Ide C
Bousso
Albert
A
Troster
Eduardo Juan
EJ
D001938:Brazil / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D008297:Male; D011446:Prospective Studies; D014132:Trachea / Q000293:injuries*; D014135:Tracheal Stenosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*