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Subglottic Stenosis Following Cardiac Surgery With Cardiopulmonary Bypass in Infants and Children

Objectives: To determine the 1) incidence of subglottic stenosis in infants and children following cardiac surgery with cardiopulmonary bypass and 2) risk factors associated with its development. Design: Retrospective cohort study. Setting: Tertiary children’s hospital in California. Patients: Infants and children who underwent cardiac surgery with cardiopulmonary bypass. Interventions: Diagnosis of subglottic stenosis by tracheoscopy. Measurements and Main Results: The incidence of subglottic stenosis at our institution during the study period was 0.7%. Young age (p = 0.014), prolonged cardiopulmonary bypass (p = 0.03), and prolonged mechanical ventilation (p < 0.01) were associated with the development of subglottic stenosis. Gender, chromosomal anomaly, presence of a cuffed endotracheal tube, and lowest core temperature during cardiopulmonary bypass were not associated with the development of subglottic stenosis. Conclusions: The incidence of subglottic stenosis was less than that previously reported in this population. Although the incidence is relatively low, subglottic stenosis is a serious complication of tracheal intubation and all measures to prevent subglottic stenosis should be undertaken.