Alexander Gelbard
Last active: 7/30/2020

The incidence of laryngotracheal stenosis in neonates with a history of ventilator-associated pneumonia.

Lowery AS, Gelbard A, Wootten C
Laryngoscope. 2019

PMID: 31800102 · PMCID: PMC7302688 · DOI:10.1002/lary.28371

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 χ test. Statistical significance was set a priori at P < .05.

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, 2019.

© 2019 The American Laryngological, Rhinological and Otological Society, Inc.

MeSH Terms (0)

Connections (1)

This publication is referenced by other Labnodes entities:

Links