Tenuous Airway in Children With Trisomy 21
Identifieur interne : 000018 ( Istex/Corpus ); précédent : 000017; suivant : 000019Tenuous Airway in Children With Trisomy 21
Auteurs : Andrew L. De Jong ; Marcelle Sulek ; Michael Nihill ; Newton O. Duncan ; Ellen M. FriedmanSource :
- The Laryngoscope [ 0023-852X ] ; 1997-03.
Abstract
Multiple 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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DOI: 10.1097/00005537-199703000-00013
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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. 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Friedman, MD, Pediatric Otolaryngology, Texas Children's Hospital, 6621 Fannin St., Houston, TX 77030, U.S.A.</correspondenceTo><objectNameGroup><objectName elementName="appendix">Appendix</objectName></objectNameGroup><linkGroup><link type="toTypesetVersion" href="file:LARY.LARY5541070313.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="1"></count><count type="tableTotal" number="2"></count><count type="referenceTotal" number="19"></count></countGroup><titleGroup><title type="main" xml:lang="en">Tenuous Airway in Children With Trisomy 21</title><title type="short" xml:lang="en">Tenuous Airway in Children With Trisomy 21</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Andrew L.</givenNames><familyName>de Jong</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Marcelle</givenNames><familyName>Sulek</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Michael</givenNames><familyName>Nihill</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Newton O.</givenNames><familyName>Duncan</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af1" corresponding="yes"><personName><givenNames>Ellen M.</givenNames><familyName>Friedman</familyName><degrees>MD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="US" type="organization"><unparsedAffiliation>Department of Otolaryngology, Baylor College of Medicine and Texas Children's Hospital, Department of Otolaryngology, Houston, TX.</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="US" type="organization"><unparsedAffiliation>Department of Cardiology, Baylor College of Medicine and Texas Children's Hospital, Department of Otolaryngology, Houston, TX.</unparsedAffiliation></affiliation></affiliationGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>Multiple 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.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Tenuous Airway in Children With Trisomy 21</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Tenuous Airway in Children With Trisomy 21</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Tenuous Airway in Children With Trisomy 21</title></titleInfo><name type="personal"><namePart type="given">Andrew L.</namePart><namePart type="family">de Jong</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Otolaryngology, Baylor College of Medicine and Texas Children's Hospital, Department of Otolaryngology, Houston, TX.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Marcelle</namePart><namePart type="family">Sulek</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Otolaryngology, Baylor College of Medicine and Texas Children's Hospital, Department of Otolaryngology, Houston, TX.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Michael</namePart><namePart type="family">Nihill</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Cardiology, Baylor College of Medicine and Texas Children's Hospital, Department of Otolaryngology, Houston, TX.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Newton O.</namePart><namePart type="family">Duncan</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Otolaryngology, Baylor College of Medicine and Texas Children's Hospital, Department of Otolaryngology, Houston, TX.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ellen M.</namePart><namePart type="family">Friedman</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Otolaryngology, Baylor College of Medicine and Texas Children's Hospital, Department of Otolaryngology, Houston, TX.</affiliation><affiliation>Ellen M. Friedman, MD, Pediatric Otolaryngology, Texas Children's Hospital, 6621 Fannin St., Houston, TX 77030, U.S.A.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>John Wiley & Sons, Inc.</publisher><place><placeTerm type="text">Hoboken, NJ</placeTerm></place><dateIssued encoding="w3cdtf">1997-03</dateIssued><dateValid encoding="w3cdtf">1996-10-14</dateValid><copyrightDate encoding="w3cdtf">1997</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">1</extent><extent unit="tables">2</extent><extent unit="references">19</extent></physicalDescription><abstract lang="en">Multiple 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.</abstract><relatedItem type="host"><titleInfo><title>The Laryngoscope</title></titleInfo><titleInfo type="abbreviated"><title>The Laryngoscope</title></titleInfo><genre type="journal">journal</genre><subject><genre>article-category</genre><topic>Article</topic></subject><identifier type="ISSN">0023-852X</identifier><identifier type="eISSN">1531-4995</identifier><identifier type="DOI">10.1002/(ISSN)1531-4995</identifier><identifier type="PublisherID">LARY</identifier><part><date>1997</date><detail type="volume"><caption>vol.</caption><number>107</number></detail><detail type="issue"><caption>no.</caption><number>3</number></detail><extent unit="pages"><start>345</start><end>350</end><total>6</total></extent></part></relatedItem><identifier type="istex">0B46AE6A37A8A498573D625E527B7276AB364233</identifier><identifier type="DOI">10.1097/00005537-199703000-00013</identifier><identifier type="ArticleID">LARY5541070313</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 1997 The Triological Society</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>John Wiley & Sons, Inc.</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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