title: Incidence and endoscopic characteristics of acute laryngeal lesions in children undergoing endotracheal intubation.
abstract: BACKGROUND
  Acute laryngeal lesions after intubation appear to be precursors of chronic lesions.
  
  
  OBJECTIVE
  To describe the incidence and type of acute laryngeal lesions after extubation in a pediatric intensive care unit (PICU).
  
  
  METHODS
  A cohort study involving children from birth to <5 years, submitted to intubation for more than 24h in the PICU of an university hospital. In the first eight hours after extubation, a flexible fiberoptic laryngoscopy (FFL) was performed at the bedside. Those with moderate to severe abnormalities underwent a second examination seven to ten days later.
  
  
  RESULTS
  177 patients were included, with a median age of 2.46 months. The mean intubation time was 8.19 days. Seventy-three (41.2%) patients had moderate or severe alterations at the FFL, with the remaining showing only minor alterations or normal results. During follow-up, 16 children from the group with moderate to severe lesions developed subglottic stenosis. One patient from the normal FFL group had subglottic stenosis, resulting in an incidence of 9.6% of chronic lesions.
  
  
  CONCLUSIONS
  Most children in the study developed mild acute laryngeal lesions caused by endotracheal intubation, which improved in a few days after extubation.
authors.affiliation: Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. Electronic address: eliandra_lima@hotmail.com.
authors.forename: Eliandra da Silveira
authors.initials: Eda S
authors.lastname: de Lima
authors.affiliation: Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
authors.forename: Maíra Alves Braga
authors.initials: MA
authors.lastname: de Oliveira
authors.affiliation: Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
authors.forename: Carolina Rocha
authors.initials: CR
authors.lastname: Barone
authors.affiliation: Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
authors.forename: Kharina Mayara Moreira
authors.initials: KM
authors.lastname: Dias
authors.affiliation: Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
authors.forename: Samanta Daiana
authors.initials: SD
authors.lastname: de Rossi
authors.affiliation: Hospital de Clínicas de Porto Alegre (HCPA), Departamento de Otorrinolaringologia, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil.
authors.forename: Claudia
authors.initials: C
authors.lastname: Schweiger
authors.affiliation: Hospital de Clínicas de Porto Alegre (HCPA), Departamento de Otorrinolaringologia, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil.
authors.forename: Denise
authors.initials: D
authors.lastname: Manica
authors.affiliation: Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil.
authors.forename: Larissa Valency
authors.initials: LV
authors.lastname: Enéas
authors.affiliation: Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil.
authors.forename: Catia de Souza
authors.initials: Cde S
authors.lastname: Saleh Netto
authors.affiliation: Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Departamento de Otorrinolaringologia, Porto Alegre, RS, Brazil.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Kuhl
authors.affiliation: Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Unidade de Terapia Intensiva Pediátrica, Porto Alegre, RS, Brazil.
authors.forename: Paulo Roberto Antonacci
authors.initials: PR
authors.lastname: Carvalho
authors.affiliation: Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Unidade de Pneumologia Pediátrica, Porto Alegre, RS, Brazil.
authors.forename: Paulo Jose Cauduro
authors.initials: PJ
authors.lastname: Marostica
mesh_terms: D000208:Acute Disease; D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D007818:Laryngeal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D007828:Laryngoscopy; D007830:Larynx / Q000293:injuries* / Q000473:pathology; D008297:Male; D012720:Severity of Illness Index
keywords: Artificial respiration; Doenças da laringe; Intubation; Intubação; Laringoscopia; Laryngeal diseases; Laryngoscopy; Respiração artificial
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