Tenuous Airway in Children With Trisomy 21

Laryngoscope - Tập 107 Số 3 - Trang 345-350 - 1997
Andrew L. de Jong1, Marcelle Sulek1, Michael R. Nihill2, Newton O. Duncan1, Ellen M. Friedman1
1Department of Otolaryngology, Baylor College of Medicine and Texas Children's Hospital, Department of Otolaryngology, Houston, TX.
2Department of Cardiology, Baylor College of Medicine and Texas Children's Hospital, Department of Otolaryngology, Houston, TX.

Tóm tắt

AbstractMultiple congenital anomalies are closely linked to Down syndrome(trisomy 21). Cardiac malformations are found in 40% of patients, a large number of whom will require a major surgical procedure. The importance of postextubation stridor in these children is frequently underestimated. A retrospective review of 99 trisomy 21 patients who underwent cardiovascular surgery revealed postextubation stridor in 24 (24.2%). Significant factors for the development of stridor included younger age (P=0.04), lower growth percentile for weight (P=0.03), and increased frequency of reintubation(P=0.04). Subglottic stenosis was found in 6 (6.1%). In 4 of these patients, an endotracheal tube of larger diameter than predicted for age was used. All 6 patients were less than the 10th percentile for weight. We conclude that Down syndrome patients deserve special considerations and modifications of standard intubation techniques for successful airway management.

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