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.
Keywords:
Intubation; Laryngeal diseases; Laryngoscopy; Artificial respiration