Cláudia Schweiger1, Denise Manica2, Denise Rotta Rutkay Pereira3, Paulo Roberto Antonacci Carvalho4, Jefferson Pedro Piva4, Gabriel Kuhl5, Leo Sekine6, Paulo José Cauduro Marostica7. 1. 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. 2. 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. 3. Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil. 4. 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. 5. 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. 6. Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Epidemiologia, Porto Alegre, RS, Brazil. 7. 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.
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). CONCLUSION: Children who developed subglottic stenosis were less sedated than children who did not develop subglottic stenosis.
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). CONCLUSION:Children who developed subglottic stenosis were less sedated than children who did not develop subglottic stenosis.