Clinical Features and Outcomes of Patients in Neonatal Intensive Care Requiring Laryngologic Consultation for Airway Disorders

김진엽; 이도영; 장현; 김동욱; 성명훈; 하정훈

Clinical Features and Outcomes of Patients in Neonatal Intensive Care Requiring Laryngologic Consultation for Airway Disorders

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Type: Academic journal

Author: 김진엽 이도영 장현 김동욱 성명훈 하정훈

Journal: 대한이비인후과학회 대한이비인후-두경부외과학회지 대한이비인후과학회지 두경부외과학 제60권 제1호 KCI Accredited Journals

Published: 2017.1

Pages: 24 - 29 (6page)

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Clinical Features and Outcomes of Patients in Neonatal Intensive Care Requiring Laryngologic Consultation for Airway Disorders

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Background and Objectives Airway problems frequently occur in neonatal patients requiring intensive care due to high prevalence of intubation history and congenital conditions that are linked to craniofacial or upper aerodigestive tract anomalies. However, many investigations on airway disorders have examined large populations of hospitalized children without focusing on those treated in the intensive care unit (ICU). Here we present the clinical features and outcomes in infants hospitalized with airway-related problems at the neonatal ICU. Subjects and Method A total 69 patients were studied from May 2005 to December 2012, with each examined by an otolaryngologist while in neonatal ICU (NICU) for possible airway problems. Descriptive analysis was used in evaluating illnesses suffered and subsequent upper airway treatments. Factors associated with tracheostomy were identified by multivariate analysis. Results The median age of infants was 30 days (range, 1-237 days), with a male-to-female ratio of 1.38. The median gestational age was 35+3 weeks, and the mean birth weight was 2.35±0.89 kg. Overall, 40 patients had histories of intubation (median duration, 36 days; range, 1-204 days). The most common diagnosis in the upper airway exam was laryngomalacia (n=12), followed by subglottic stenosis (n=10) and micrognathia (n=8). Tracheostomy was performed in 38 patients (55.1%). In multivariate analysis, intubation history was identified as the only variable demonstrating a significant independent association with tracheostomy (p=0.006). Conclusion Upper airway problems in NICU patients are due to a variety of disorders. Precise diagnosis and treatment is achievable through bedside and intraoperative assessments. Patients with a history of intubation are at increased risk of tracheostomy. Korean J Otorhinolaryngol-Head Neck Surg 2017;60(1):24-9

#Neonatal intensive care unit #Subglottic stenosis #Tracheostomy #Upper airway obstruction.

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References (18)

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Al-Samri M / 2010 / Tracheostomy in children: a population-based experience over 17 years / Pediatr Pulmonol 45 (5) : 487 ~ 493

Baud O / 2004 / Postnatal steroid treatment and brain development / Arch Dis Child Fetal Neonatal Ed 89 (2) : F96 ~ F100

Berry JG / 2010 / Patient characteristics associated with in-hospital mortality in children following tracheotomy / Arch Dis Child 95 (9) : 703 ~ 710

Dankle SK / 1986 / Risk factors for neonatal acquired subglottic stenosis / Ann Otol Rhinol Laryngol 95 (6 Pt 1) : 626 ~ 630

Freeland AP / 1974 / Developmental influences of infant tracheostomy / J Laryngol Otol 88 (10) : 927 ~ 936

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