Lj. Hoeve et al., THERAPEUTIC REINTUBATION FOR POST-INTUBATION LARYNGOTRACHEAL INJURY IN PRETERM INFANTS, International journal of pediatric otorhinolaryngology, 31(1), 1995, pp. 7-13
The failure to extubate a preterm infant after prolonged intubation is
often caused by laryngotracheal injury. This condition is treated by
tracheotomy, anterior cricoid split, or often, by reintubation and sub
sequent extubation attempts in a later stage. To assess the value of r
eintubation as treatment of post-intubation injury, we retrospectively
studied a group of preterm infants from the neonatal intensive care u
nit in the Sophia Children's Hospital. Three categories of injury were
distinguished according to the findings at laryngobronchoscopy: (a) e
dema or superficial lesions, (b) ulcerations and edema and (c) granula
tions. Twenty-three infants were therapeutically reintubated after pos
t-intubation injury was diagnosed, for a mean period of 17 days. The t
herapy was successful in 22 patients, and a failure in one. The follow
-up period was a mean 34 months. The result and the duration of the tr
eatment vary with the category of the injury and the condition of the
patient. Therapeutic reintubation is compared with alternatives such a
s anterior cricoid split and tracheotomy. We conclude that reintubatio
n is a valuable therapy that should precede the decision for surgery.