The effect of continuous positive airway pressure (CPAP) application on airway problems in pediatric patients with subglottic stenosis who undergo balloon dilatation
Abstract Background Subglottic stenosis is a significant clinical challenge in pediatric anesthesia, often necessitating interventions that can lead to various postoperative complications. The aim of this study was to determine the effect of prophylactic continuous positive airway pressure (CPAP) ap...
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BMC
2025-01-01
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| Series: | Perioperative Medicine |
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| Online Access: | https://doi.org/10.1186/s13741-024-00478-5 |
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| author | Zeliha Tuncel Şenay Göksu Özlem Deligöz Kemal Tolga Saracoglu Abdulatif Albasha Bushra M. Abdallah Ayten Saracoglu |
| author_facet | Zeliha Tuncel Şenay Göksu Özlem Deligöz Kemal Tolga Saracoglu Abdulatif Albasha Bushra M. Abdallah Ayten Saracoglu |
| author_sort | Zeliha Tuncel |
| collection | DOAJ |
| description | Abstract Background Subglottic stenosis is a significant clinical challenge in pediatric anesthesia, often necessitating interventions that can lead to various postoperative complications. The aim of this study was to determine the effect of prophylactic continuous positive airway pressure (CPAP) application on recovery time and airway complications in pediatric patients with subglottic stenosis undergoing balloon dilatation. Methods A prospective, double-blinded, parallel-group, randomized controlled study was conducted at Health Sciences University Ümraniye Training and Research Hospital on pediatric patients with subglottic stenosis, aged from 0 to 12 years and who underwent elective balloon dilatation under general anesthesia. Patients were randomized in a 1:1 ratio into the CPAP or non-CPAP group. The primary outcome was the duration of recovery time. Secondary outcomes included bronchospasm, the number of desaturation episodes, intubation, tracheostomy, and the need for intensive care. Results A total of 84 patients were enrolled in this randomized controlled trial, 81 of which received the allocated treatment and were analyzed (non-CPAP n = 41, CPAP n = 40). Compared to controls, the proportions of bronchospasm, tracheal secretion, need for intensive care, and tracheostomy were consistently lower in the CPAP group, whereas the requirement of intubation was higher. Further, the mean recovery time was significantly shorter in the CPAP group compared to the non-CPAP group (mean difference − 3.3 min, 95%CI − 5.16 to − 1.44, p = 0.0007). Despite lacking statistical significance, the CPAP group had reduced odds of developing bronchospasm, tracheal secretion, need for intensive care, and tracheostomy, but higher odds of requiring intubation when compared to the controls. Conclusion Prophylactic CPAP application following therapeutic balloon dilatation in pediatric patients who have developed subglottic stenosis due to acquired or congenital causes appears to effectively shorten recovery time and may have a role in decreasing postoperative pulmonary complications; however, more research is recommended to further confirm these findings. Trial registration The protocol for this clinical trial was retrospectively registered on clinicaltrials.gov with registration ID NCT06183515 on 30 November 2023. |
| format | Article |
| id | doaj-art-fa8890607b12411a8dfbc2fa891533cc |
| institution | Kabale University |
| issn | 2047-0525 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Perioperative Medicine |
| spelling | doaj-art-fa8890607b12411a8dfbc2fa891533cc2025-01-26T12:45:06ZengBMCPerioperative Medicine2047-05252025-01-011411810.1186/s13741-024-00478-5The effect of continuous positive airway pressure (CPAP) application on airway problems in pediatric patients with subglottic stenosis who undergo balloon dilatationZeliha Tuncel0Şenay Göksu1Özlem Deligöz2Kemal Tolga Saracoglu3Abdulatif Albasha4Bushra M. Abdallah5Ayten Saracoglu6Department of Anesthesia and Reanimation, Ümraniye Training and Research Hospital, University of Health SciencesDepartment of Anesthesia and Reanimation, Ümraniye Training and Research Hospital, University of Health SciencesDepartment of Anesthesia and Reanimation, Haydarpaşa Numune Training and Research Hospital, University of Health SciencesDepartment of Anesthesiology, ICU, and Perioperative Medicine, Hazm Mebaireek General Hospital, Hamad Medical CorporationDepartment of Anesthesiology, ICU, and Perioperative Medicine, Hamad General Hospital, Hamad Medical CorporationCollege of Medicine, QU Health, Qatar UniversityCollege of Medicine, QU Health, Qatar UniversityAbstract Background Subglottic stenosis is a significant clinical challenge in pediatric anesthesia, often necessitating interventions that can lead to various postoperative complications. The aim of this study was to determine the effect of prophylactic continuous positive airway pressure (CPAP) application on recovery time and airway complications in pediatric patients with subglottic stenosis undergoing balloon dilatation. Methods A prospective, double-blinded, parallel-group, randomized controlled study was conducted at Health Sciences University Ümraniye Training and Research Hospital on pediatric patients with subglottic stenosis, aged from 0 to 12 years and who underwent elective balloon dilatation under general anesthesia. Patients were randomized in a 1:1 ratio into the CPAP or non-CPAP group. The primary outcome was the duration of recovery time. Secondary outcomes included bronchospasm, the number of desaturation episodes, intubation, tracheostomy, and the need for intensive care. Results A total of 84 patients were enrolled in this randomized controlled trial, 81 of which received the allocated treatment and were analyzed (non-CPAP n = 41, CPAP n = 40). Compared to controls, the proportions of bronchospasm, tracheal secretion, need for intensive care, and tracheostomy were consistently lower in the CPAP group, whereas the requirement of intubation was higher. Further, the mean recovery time was significantly shorter in the CPAP group compared to the non-CPAP group (mean difference − 3.3 min, 95%CI − 5.16 to − 1.44, p = 0.0007). Despite lacking statistical significance, the CPAP group had reduced odds of developing bronchospasm, tracheal secretion, need for intensive care, and tracheostomy, but higher odds of requiring intubation when compared to the controls. Conclusion Prophylactic CPAP application following therapeutic balloon dilatation in pediatric patients who have developed subglottic stenosis due to acquired or congenital causes appears to effectively shorten recovery time and may have a role in decreasing postoperative pulmonary complications; however, more research is recommended to further confirm these findings. Trial registration The protocol for this clinical trial was retrospectively registered on clinicaltrials.gov with registration ID NCT06183515 on 30 November 2023.https://doi.org/10.1186/s13741-024-00478-5Pediatric airwaySubglottic stenosisCPAPApneic ventilation |
| spellingShingle | Zeliha Tuncel Şenay Göksu Özlem Deligöz Kemal Tolga Saracoglu Abdulatif Albasha Bushra M. Abdallah Ayten Saracoglu The effect of continuous positive airway pressure (CPAP) application on airway problems in pediatric patients with subglottic stenosis who undergo balloon dilatation Perioperative Medicine Pediatric airway Subglottic stenosis CPAP Apneic ventilation |
| title | The effect of continuous positive airway pressure (CPAP) application on airway problems in pediatric patients with subglottic stenosis who undergo balloon dilatation |
| title_full | The effect of continuous positive airway pressure (CPAP) application on airway problems in pediatric patients with subglottic stenosis who undergo balloon dilatation |
| title_fullStr | The effect of continuous positive airway pressure (CPAP) application on airway problems in pediatric patients with subglottic stenosis who undergo balloon dilatation |
| title_full_unstemmed | The effect of continuous positive airway pressure (CPAP) application on airway problems in pediatric patients with subglottic stenosis who undergo balloon dilatation |
| title_short | The effect of continuous positive airway pressure (CPAP) application on airway problems in pediatric patients with subglottic stenosis who undergo balloon dilatation |
| title_sort | effect of continuous positive airway pressure cpap application on airway problems in pediatric patients with subglottic stenosis who undergo balloon dilatation |
| topic | Pediatric airway Subglottic stenosis CPAP Apneic ventilation |
| url | https://doi.org/10.1186/s13741-024-00478-5 |
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