Incidência e características endoscópicas de lesões agudas laríngeas em crianças submetidas à intubação endotraqueal

Abstract

Introduction 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 24 h 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. Conclusion Most children in the study developed mild acute laryngeal lesions caused by endotracheal intubation, which improved in a few days after extubation.