Document Detail


Iatrogenic perinatal pharyngoesophageal injury: a disease of prematurity.
MedLine Citation:
PMID:  20144485     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Perinatal pharyngoesophageal instrumentation, including endotracheal intubation, oral suctioning, and feeding tube placement, is often necessary but risks tissue damage. Our objective was to estimate the incidence of iatrogenic perinatal pharyngoesophageal injury (IPPI) in preterm versus term infants in a children's hospital neonatal intensive care unit (NICU). A secondary goal was to explore the clinical characteristics and outcomes associated with these complications. METHODS: All NICU discharge summaries from 2004 to 2008 were searched for IPPI-related keywords. Highlighted records were reviewed and the incidence of complications calculated by gestational age and weight. RESULTS: Of 5910 total NICU discharges, 6 cases of IPPI were identified, for an overall incidence of 0.10%. All injuries occurred in infants less than 33 weeks gestational age and 1500g, with a trend towards higher incidence with increasing prematurity. The incidence of IPPI rose to 4/1321 (0.30%) at 27-32 weeks and 2/521 (0.38%) at less than 27 weeks gestation. Similarly, IPPI occurred in 3/675 (0.44%) babies born at 1000-1500g and 3/642 (0.47%) babies below 1000g. All affected infants survived with conservative management. CONCLUSIONS: IPPI is a rare but serious complication of perinatal airway instrumentation and is primarily a disease of prematurity. In this sizeable cohort, no complications occurred in term infants, and the incidence of injury increased with decreasing gestational age and weight. This increased propensity towards injury should prompt special care when performing even routine airway procedures on premature neonates.
Authors:
Theodore A Schuman; Britni Jacobs; William Walsh; Steven L Goudy
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Publication Detail:
Type:  Journal Article     Date:  2010-02-07
Journal Detail:
Title:  International journal of pediatric otorhinolaryngology     Volume:  74     ISSN:  1872-8464     ISO Abbreviation:  Int. J. Pediatr. Otorhinolaryngol.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-08     Completed Date:  2010-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003603     Medline TA:  Int J Pediatr Otorhinolaryngol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  393-7     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology - Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA. theodore.schuman@vanderbilt.edu
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MeSH Terms
Descriptor/Qualifier:
Enteral Nutrition / adverse effects
Esophagus / injuries*
Gestational Age
Humans
Iatrogenic Disease / epidemiology*
Incidence
Infant, Newborn
Infant, Premature*
Infant, Very Low Birth Weight
Intensive Care Units, Neonatal*
Intubation, Intratracheal / adverse effects
Perinatal Care
Pharynx / injuries*
Suction / adverse effects
Tennessee / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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