Delayed Airway Injuries After Perioperative Intubation in Pediatric Patients with Down Syndrome: A Preliminary Analysis
Presenter Status
Medical Student
Abstract Type
Clinical Research
Primary Mentor or Principal Investigator
Micheal Puricelli
Presentation Type
Poster
Start Date
21-5-2026 12:00 PM
End Date
21-5-2026 1:00 PM
Abstract Text
Background:
Down Syndrome, or Trisomy 21, is one of the most common genomic anomalies in humans. While it manifests in several systems, its impacts on the airway are prominent and well documented, indicating that the prevalence of airway anomalies is significantly higher than in patients without Down Syndrome. As such, careful airway management in these patients is critical. However, the impacts of perioperative endotracheal intubation factors like endotracheal tube (ETT) size and appropriateness based on current formulas remain unclear.
Objectives/Goal:
This study aims to quantify how early life perioperative intubation factors affect long-term airway outcomes in patients with Down Syndrome.
Methods/Design:
TriNetX was used to build a cohort of patients from Children’s Mercy Hospital with Down Syndrome who underwent surgery requiring intubation within the first year of life. Patient records were then reviewed for relevant data points, including immediate and delayed airway complications and diagnoses. Airway anomaly diagnoses were used for this analysis. Statistical tests included Pearson Chi-Square tests to evaluate the association between tube size and appropriateness and delayed airway diagnoses.
Results:
The query generated 318 total patients. 80 charts were screened for this analysis, and 46 met criteria for inclusion. 3.0mm, 3.5mm, and 4.0mm ETTs were used for 28, 17, and 1 patients, respectively. 37 were appropriately sized while 9 were inappropriately sized. No significant differences in airway anomalies were found between the ETT size groups (p=0.785). Similarly, no significant differences in anomalies were found between the appropriate and inappropriately sized groups (p=0.833).
Conclusions:
Based on this preliminary analysis, ETT size (3.0mm, 3.5mm, and 4.0mm) and appropriateness did not impact future airway diagnoses. This suggests that, within a certain window, flexibility exists in the perioperative management of pediatric patients with Down Syndrome. While this would expand size recommendations and alter sizing appropriateness designations, further data collection and analysis must be completed to improve the power of this study, and data beyond the first year of life is needed to further generalize these findings.
Delayed Airway Injuries After Perioperative Intubation in Pediatric Patients with Down Syndrome: A Preliminary Analysis
Background:
Down Syndrome, or Trisomy 21, is one of the most common genomic anomalies in humans. While it manifests in several systems, its impacts on the airway are prominent and well documented, indicating that the prevalence of airway anomalies is significantly higher than in patients without Down Syndrome. As such, careful airway management in these patients is critical. However, the impacts of perioperative endotracheal intubation factors like endotracheal tube (ETT) size and appropriateness based on current formulas remain unclear.
Objectives/Goal:
This study aims to quantify how early life perioperative intubation factors affect long-term airway outcomes in patients with Down Syndrome.
Methods/Design:
TriNetX was used to build a cohort of patients from Children’s Mercy Hospital with Down Syndrome who underwent surgery requiring intubation within the first year of life. Patient records were then reviewed for relevant data points, including immediate and delayed airway complications and diagnoses. Airway anomaly diagnoses were used for this analysis. Statistical tests included Pearson Chi-Square tests to evaluate the association between tube size and appropriateness and delayed airway diagnoses.
Results:
The query generated 318 total patients. 80 charts were screened for this analysis, and 46 met criteria for inclusion. 3.0mm, 3.5mm, and 4.0mm ETTs were used for 28, 17, and 1 patients, respectively. 37 were appropriately sized while 9 were inappropriately sized. No significant differences in airway anomalies were found between the ETT size groups (p=0.785). Similarly, no significant differences in anomalies were found between the appropriate and inappropriately sized groups (p=0.833).
Conclusions:
Based on this preliminary analysis, ETT size (3.0mm, 3.5mm, and 4.0mm) and appropriateness did not impact future airway diagnoses. This suggests that, within a certain window, flexibility exists in the perioperative management of pediatric patients with Down Syndrome. While this would expand size recommendations and alter sizing appropriateness designations, further data collection and analysis must be completed to improve the power of this study, and data beyond the first year of life is needed to further generalize these findings.
Comments
Restricted to Title/Author List/Abstract only as requested by primary author
Poster Board Number: 28