Factores relacionados con el desarrollo de croup post extubación en pacientes pediátricos en el hospital Santa Clara
Factores relacionados con el desarrollo de croup post extubación en pacientes pediátricos en el hospital Santa Clara
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Background. Endotracheal intubation is often necessary in critically ill pediatric patients. However, this intervention can result in laryngeal edema, postextubation sttidor, and upper airway obstruction, carrying significant morbidity and mortality.
Objective. Our objective was to evaluate the risk factors for postextubation laryngeal stridor in pediatric patients.
Design. A prospective cohort study.
Patients and methods. All pediatric patients admitted to lntensive Care Unit (ICU) of Santa Clara Hospital between April 2001 and October 2002, and requiring endotracheal intubation, were prospectively observed. Recorded information included the presence of predictor variables and postextubation stridor.
Results. After adjustment for age, experience of person who intubated the patient, number of changes of endotracheal tube, use of a endotracheal tube big for the age of the patient,nasogastric tube use, metoclopramide use, systemic steroids previuous to extubation, and wheezing bronchitis and upper airway obstruction as indication for endotracheal intubation, we found that male gender (OR, 2.94; CI 95%, 1.12-7.73; p = 0.02) and a duration of intubation equal or greater to five days (OR,2.70; CI 95%, 1.09-6.66; p = 0.03) were independent predictors of postextubation stridor in children.
Conclusions. We conclude that male gender patients and patients with a duration of intubation equal or greater five days have increased risk to have postextubation stridor, and efforts should be made to prevent it in this group of patients.
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