Subglottic Stenosis Following Cardiac Surgery With Cardiopulmonary Bypass in Infants and Children

Pediatr Crit Care Med. 2017 May;18(5):429-433. doi: 10.1097/PCC.0000000000001125.

Abstract

Objectives: To determine the 1) incidence of subglottic stenosis in infants and children following cardiac surgery with cardiopulmonary bypass and 2) risk factors associated with its development.

Design: Retrospective cohort study.

Setting: Tertiary children's hospital in California.

Patients: Infants and children who underwent cardiac surgery with cardiopulmonary bypass.

Interventions: Diagnosis of subglottic stenosis by tracheoscopy.

Measurements and main results: The incidence of subglottic stenosis at our institution during the study period was 0.7%. Young age (p = 0.014), prolonged cardiopulmonary bypass (p = 0.03), and prolonged mechanical ventilation (p < 0.01) were associated with the development of subglottic stenosis. Gender, chromosomal anomaly, presence of a cuffed endotracheal tube, and lowest core temperature during cardiopulmonary bypass were not associated with the development of subglottic stenosis.

Conclusions: The incidence of subglottic stenosis was less than that previously reported in this population. Although the incidence is relatively low, subglottic stenosis is a serious complication of tracheal intubation and all measures to prevent subglottic stenosis should be undertaken.

MeSH terms

  • Adolescent
  • Cardiac Surgical Procedures*
  • Cardiopulmonary Bypass*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Laryngostenosis / diagnostic imaging
  • Laryngostenosis / epidemiology*
  • Laryngostenosis / etiology*
  • Male
  • Outcome Assessment, Health Care
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology*
  • Retrospective Studies
  • Risk Factors