{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T23:46:56Z","timestamp":1792108016572,"version":"4.4.0"},"reference-count":35,"publisher":"BMJ","issue":"4","funder":[{"name":"Telethon Foundation WA"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"accepted":{"date-parts":[[2017,8,4]]},"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To analyse current incidence and risk factors associated with severe acquired subglottic stenosis (SASGS) requiring surgical intervention in neonates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Retrospective case\u2013control study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Sole tertiary children\u2019s hospital.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>Patients who underwent surgical intervention for SASGS from January 2006 to December 2014. For each neonatal intensive care unit (NICU) graduate with acquired SASGS, two controls were selected (matched for gestation and year of birth).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcomes and measures<\/jats:title>\n                  <jats:p>Incidences were calculated and cases and controls compared using conditional logistic regression analysis to identify risk factors for SASGS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Thirty-seven NICU graduates required surgical intervention for SASGS of whom 35 were &lt;30-week gestation at birth. The incidence of SASGS in surviving children who had required ventilation in the neonatal period was 27\/2913 (0.93%). Incidence was higher in infants &lt;28-week gestation (24\/623=3.8%) compared with infants \u226528-week gestation (3\/2290=0.13%; p=0.0001). On univariate analysis, risk factors for SASGS were: higher number of intubations (4\u2009vs 2; p&lt;0.001); longer duration ventilation (16\u2009vs 9.5 days; p&lt;0.001); unplanned extubation (45.7%\u2009vs 20.0%; p=0.007); traumatic intubation (34.3%\u2009vs 7.1%; p=0.003) and oversized endotracheal tubes (ETTs) (74.3%\u2009vs 42.9%; p=0.001). On multivariate analysis, risk factors for SASGS were: Sherman ratio &gt;0.1 (adjusted OR (aOR) 6.40; 95%\u2009CI 1.65 to 24.77); more than five\u2009previous intubations (aOR 3.74; 95%\u2009CI 1.15 to 12.19); traumatic intubation (aOR 3.37; 95%\u2009CI 1.01 to 11.26).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>SASGS is a serious consequence of intubation for mechanical ventilation in NICU graduates, especially in preterm infants. Minimising trauma during intubations, avoiding recurrent extubation\/reintubations and using appropriate sized ETTs may help prevent this serious complication.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/archdischild-2017-312962","type":"journal-article","created":{"date-parts":[[2017,9,2]],"date-time":"2017-09-02T20:30:16Z","timestamp":1504384216000},"page":"F349-F354","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":50,"title":["Severe acquired subglottic stenosis in neonatal intensive care graduates: a case\u2013control study"],"prefix":"10.1136","volume":"103","author":[{"given":"Rebecca E","family":"Thomas","sequence":"first","affiliation":[{"name":"Neonatal Clinical Care Unit, Princess Margaret Hospital for Children and King Edward Memorial Hospital for Women, Perth, Western Australia, Australia"},{"name":"School of Paediatrics and Child Health, Centre for Neonatal Research and Education, University of Western Australia, Perth, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shripada C","family":"Rao","sequence":"additional","affiliation":[{"name":"Neonatal Clinical Care Unit, Princess Margaret Hospital for Children and King Edward Memorial Hospital for Women, Perth, Western Australia, Australia"},{"name":"School of Paediatrics and Child Health, Centre for Neonatal Research and Education, University of Western Australia, Perth, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corrado","family":"Minutillo","sequence":"additional","affiliation":[{"name":"Neonatal Clinical Care Unit, Princess Margaret Hospital for Children and King Edward Memorial Hospital for Women, Perth, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shyan","family":"Vijayasekaran","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Princess Margaret Hospital for Children, Perth, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A","family":"Nathan","sequence":"additional","affiliation":[{"name":"Biostatistics and Research Design Unit, School of Women\u2019s and Infants\u2019 Health, University of Western Australia, Perth, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,9,2]]},"reference":[{"key":"2025090510345417000_103.4.F349.1","doi-asserted-by":"publisher","DOI":"10.1177\/000348947608500505"},{"key":"2025090510345417000_103.4.F349.2","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1177\/000348948008900605","article-title":"Acquired stenosis of the upper airway in neonates. 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