title: Undersedation is a risk factor for the development of subglottic stenosis in intubated children.
abstract: OBJECTIVE
  To analyze the level of sedation in intubated children as a risk factor for the development of subglottic stenosis.
  
  
  METHODS
  All patients between 30 days and 5 years of age who required endotracheal intubation in the pediatric intensive care unit between 2013 and 2014 were included in this prospective study. They were monitored daily and COMFORT-B scores were obtained. Flexible fiber-optic laryngoscopy was performed within eight hours of extubation, and repeated seven to ten days later if the first examination showed moderate to severe laryngeal injuries. If these lesions persisted and/or if the child developed symptoms in the follow-up period, microlaryngoscopy under general anesthesia was performed to evaluate for subglottic stenosis.
  
  
  RESULTS
  The study included 36 children. Incidence of subglottic stenosis was 11.1%. Children with subglottic stenosis had a higher percentage of COMFORT-B scores between 23 and 30 (undersedated) than those who did not develop subglottic stenosis (15.8% vs. 3.65%, p=0.004).
  
  
  CONCLUSIONS
  Children who developed subglottic stenosis were less sedated than children who did not develop subglottic stenosis.
authors.affiliation: Hospital de Clínicas de Porto Alegre, Unidade 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. Electronic address: causch@hotmail.com.
authors.forename: Cláudia
authors.initials: C
authors.lastname: Schweiger
authors.affiliation: Hospital de Clínicas de Porto Alegre, Unidade 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: Denise Rotta Rutkay
authors.initials: DRR
authors.lastname: Pereira
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, Unidade de Terapia Intensiva Pediátrica, Porto Alegre, RS, Brazil.
authors.forename: Paulo Roberto Antonacci
authors.initials: PRA
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, Unidade de Terapia Intensiva Pediátrica, Porto Alegre, RS, Brazil.
authors.forename: Jefferson Pedro
authors.initials: JP
authors.lastname: Piva
authors.affiliation: Hospital de Clínicas de Porto Alegre, Unidade de Otorrinolaringologia, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul (UFRGS), Departamento de Otorrinolaringologia e Oftalmologia, 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 Epidemiologia, Porto Alegre, RS, Brazil.
authors.forename: Leo
authors.initials: L
authors.lastname: Sekine
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, Unidade de Pneumologia Pediátrica, Porto Alegre, RS, Brazil.
authors.forename: Paulo José Cauduro
authors.initials: PJC
authors.lastname: Marostica
mesh_terms: D060666:Airway Extubation; D002675:Child, Preschool; D054810:Deep Sedation; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D007829:Laryngostenosis / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: Airway stenosis/reconstruction; Children; Crianças; Estenose/Reconstrução das vias aéreas; Laringe; Larynx