Tubos endotraqueales con cuff en anestesia pediátrica: ¿Aumentan el riesgo de estridor post-extubación? Estudio observacional, cohorte prospectiva

Abstract

The traditional pediatric airway model precludes the use of cuffed endotracheal tubes because of concerns regarding subglottic mucosal injury. Cuffed tubes have advantages which together with a change in the pediatric airway paradigm have made the practitioners to consider its use in children. Nevertheless some uneasiness remains about cuff employ in the neonatal population, specially preterms. A study was designed to determine if cuffed tracheal tubes increased the post-extubation stridor risk in children. Methods: Information concerning 535 children under 11 years old undergoing general anesthesia with tracheal intubation was prospectively recollected during a year. The choice of the type of tube was left to the anesthesiologist in charge. The post-extubation stridor risk was compared with logistic regression between those intubated with and those without cuffed tubes. Results: The post-extubation stridor incidence was 19·1,000 patients-year; Conf. Interval 95% [9-34·1,000]. The cuffed tracheal tubes effect on stridor risk, (adjusting for confounders), was non-significant: OR = 2,2; Conf. Interval 95% [0,2-20]; p = 0,5. Conclusions: The use of cuffed endotracheal tubes did not increase the risk of post-extubation stridor in children.