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The Incidence of Laryngotracheal Stenosis in Neonates with a History of Ventilator-Associated Pneumonia
- Source :
- Laryngoscope
- Publication Year :
- 2019
-
Abstract
- Objectives/hypothesis Neonatal patients requiring prolonged intubation are susceptible to both infection and laryngotracheal stenosis (LTS). This study investigated the effect of ventilator-associated pneumonia (VAP) on the development of LTS in neonates. Study design Retrospective case-control study. Methods The incidence of LTS in neonates with VAP was compared with the incidence of LTS in matched intubated controls without VAP. Patients were treated at a tertiary-care medical center from 2004 to 2014. Eligible patient records were assessed for the development of LTS. Demographics, medical comorbidities, infection characteristics, and treatment variables were compared using unpaired t test or χ2 test. Statistical significance was set a priori at P Results When comparing the VAP patients with matched non-VAP controls, we found no significant differences in the incidence of LTS (VAP vs. non-VAP, 8.3% vs. 6.7%; P = .73). In subgroup analysis of the VAP cohort, LTS and non-LTS patients demonstrated similar VAP organisms on broncho-alveolar lavage (Klebsiella pneumoniae, Pseudomonas aeroginosa, Escherichia coli, methicillin-resistant Staphylococcus aureus, Streptococcus pneumoniae, and Enterobacter). Additionally, within the VAP cohort, LTS and non-LTS patients showed similar gestational age (LTS vs. non-LTS, 31.3 days vs. 28.1 days; P = .22), birth weight (LTS vs. non-LTS, 1.6 kg vs. 1.2 kg; P = .33), and similar intubation duration (LTS vs. non-LTS, 37.8 days vs. 27.5 days; P = .52). Conclusions In this neonatal cohort, VAP was not associated with an increased incidence of LTS. Given severity of the burden of LTS on the healthcare system, multi-institutional longitudinal investigation into contributing risk factors for neonatal LTS is warranted. Level of evidence NA Laryngoscope, 130:2252-2255, 2020.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Birth weight
Bronchoalveolar Lavage
Article
03 medical and health sciences
0302 clinical medicine
Risk Factors
030225 pediatrics
Internal medicine
Intensive Care Units, Neonatal
Medicine
Intubation
Humans
030212 general & internal medicine
Retrospective Studies
business.industry
Incidence (epidemiology)
Incidence
Ventilator-associated pneumonia
Infant, Newborn
Gestational age
Pneumonia, Ventilator-Associated
Laryngostenosis
medicine.disease
bacterial infections and mycoses
respiratory tract diseases
Pneumonia
Otorhinolaryngology
Case-Control Studies
Cohort
lipids (amino acids, peptides, and proteins)
Female
business
Tracheal Stenosis
Bronchoalveolar Lavage Fluid
Laryngotracheal stenosis
Subjects
Details
- Language :
- English
- ISSN :
- 22522255
- Database :
- OpenAIRE
- Journal :
- Laryngoscope
- Accession number :
- edsair.doi.dedup.....ea906349632073419e8ec1e98e406249