| Should all newborns who undergo patent ductus arteriosus ligation be examined for vocal fold mobility? | |
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MedLine Citation:
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PMID: 19507238 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES/HYPOTHESIS: To determine the incidence of left vocal fold paralysis (LVFP) in premature infants who undergo patent ductus arteriosus (PDA) ligation. STUDY DESIGN: Prospective cohort. METHODS: The study was carried out in the newborn intensive care unit (NICU) of a tertiary academic medical center. Eighty-six premature newborns who underwent ligation of a PDA were examined postextubation with fiberoptic laryngoscopy to assess vocal fold mobility, regardless of laryngeal symptom status. RESULTS: Fourteen infants (16%) had LVFP. All were <28 weeks postmenstrual age (PMA) at birth and <1,250 g at PDA ligation, and were significantly less mature and smaller than infants without LVFP. Infants <28 weeks PMA at birth and <1,250 g at ligation had an incidence of LVFP of 23% and 24%, respectively. Fourteen percent of the infants with LVFP did not have laryngeal symptoms and would have been missed had these been the sole criteria for assessing vocal fold mobility. CONCLUSIONS: The incidence of LVFP after PDA ligation in the NICU is high, and some cases may be missed if laryngoscopy is performed only when laryngeal symptoms are present. Infants <28 weeks PMA at birth and <1,250 g at ligation are at especially high risk. Vocal fold mobility should be documented by laryngoscopy on all high-risk infants undergoing a PDA ligation in the NICU regardless of laryngeal symptom status, and on all infants with relevant symptoms. The high incidence of this complication warrants greater efforts to prospectively assess vocal fold mobility status in high-risk infants who undergo PDA ligation. |
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Authors:
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Marshall E Smith; Jerald D King; Abdelaziz Elsherif; Harlan R Muntz; Albert H Park; Peter C Kouretas |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Laryngoscope Volume: 119 ISSN: 1531-4995 ISO Abbreviation: Laryngoscope Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-07-29 Completed Date: 2009-08-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8607378 Medline TA: Laryngoscope Country: United States |
Other Details:
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Languages: eng Pagination: 1606-9 Citation Subset: IM |
Affiliation:
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University of Utah School of Medicine, Salt Lake City, USA. marshall.smith@hsc.utah.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cohort Studies Decision Making Ductus Arteriosus, Patent / surgery Female Humans Infant, Newborn Infant, Premature* Intensive Care Units, Neonatal Intraoperative Complications / diagnosis, epidemiology, etiology* Intubation, Intratracheal / adverse effects, methods Laryngoscopy / methods Ligation / adverse effects, methods Logistic Models Male Neonatal Screening / methods Probability Prognosis Prospective Studies Recurrent Laryngeal Nerve / injuries* Risk Assessment Severity of Illness Index Vocal Cord Paralysis / diagnosis, epidemiology*, etiology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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