Risk factors for post-extubation stridor in pediatric cardiac intensive care unit: a single-center retrospective study
5 affiliations
- 1Division of Cardiology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- 2Center for Clinical Epidemiology and Clinical Statistics, Department of Biomedical Informatics and Clinical Epidemiology (BioCE), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- 3Division of Pulmonology and Critical Care, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- 4Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- 5Division of Pulmonology and Sleep Medicine, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200 Thailand
Abstract
Background: Post-extubation stridor (PES) is a frequent and clinically significant complication among pediatric cardiac intensive care unit (PCICU) patients, particularly those with congenital heart disease (CHD). This study aimed to determine the incidence, associated risk factors, and outcomes of PES in this population.
Methods: This retrospective cohort study included children aged 1 month to 18 years who underwent planned extubation after more than 24 h of mechanical ventilation in the PCICU at Chiang Mai University Hospital between July 2016 and June 2024. Demographic, clinical, and ventilatory variables were retrieved from electronic medical records. Univariable and multivariable mixed-effects logistic regression analyses were performed to identify independent predictors of PES.
Results: Among 494 extubation episodes from 380 children, PES occurred in 25.5% of attempts. Patients who developed PES were younger, low body weight, and had longer ventilation duration compared with those without PES. In multivariable analysis, lower body weight (OR 0.84; 95% CI, 0.73–0.97) and mechanical ventilation exceeding 7 days (OR 1.83; 95% CI, 1.04–3.23) remained significant independent predictors.
Conclusions: PES was common among pediatric cardiac patients and was independently associated with lower body weight at extubation and prolonged mechanical ventilation. Recognition of children at higher risk may support targeted preventive strategies and improve post-extubation outcomes.
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BibTeX
@article{saengsin2026risk,
title = {{Risk factors for post-extubation stridor in pediatric cardiac intensive care unit: a single-center retrospective study}},
author = {Kwannapas Saengsin and Pakpoom Wongyikul and Phichayut Phinyo and Thirasak Borisuthipandit and Rekwan Sittiwangkul and Suchaya Silvilairat and Krit Makonkawkeyoon and Saviga Sethasathien and Tin Ayurag and Nateewit Wiwatkamonchai and Kanokkarn Sunkonkit},
journal = {BMC Pediatrics},
year = {2026},
month = aug,
doi = {10.1186/s12887-026-07478-y},
url = {https://doi.org/10.1186/s12887-026-07478-y},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Risk factors for post-extubation stridor in pediatric cardiac intensive care unit: a single-center retrospective study
AU - Kwannapas Saengsin
AU - Pakpoom Wongyikul
AU - Phichayut Phinyo
AU - Thirasak Borisuthipandit
AU - Rekwan Sittiwangkul
AU - Suchaya Silvilairat
AU - Krit Makonkawkeyoon
AU - Saviga Sethasathien
AU - Tin Ayurag
AU - Nateewit Wiwatkamonchai
AU - Kanokkarn Sunkonkit
PY - 2026
DA - 2026/08/08
JO - BMC Pediatrics
DO - 10.1186/s12887-026-07478-y
UR - https://doi.org/10.1186/s12887-026-07478-y
AB - Background: Post-extubation stridor (PES) is a frequent and clinically significant complication among pediatric cardiac intensive care unit (PCICU) patients, particularly those with congenital heart disease (CHD). This study aimed to determine the incidence, associated risk factors, and outcomes of PES in this population. Methods: This retrospective cohort study included children aged 1 month to 18 years who underwent planned extubation after more than 24 h of mechanical ventilation in the PCICU at Chiang Mai University Hospital between July 2016 and June 2024. Demographic, clinical, and ventilatory variables were retrieved from electronic medical records. Univariable and multivariable mixed-effects logistic regression analyses were performed to identify independent predictors of PES. Results: Among 494 extubation episodes from 380 children, PES occurred in 25.5% of attempts. Patients who developed PES were younger, low body weight, and had longer ventilation duration compared with those without PES. In multivariable analysis, lower body weight (OR 0.84; 95% CI, 0.73–0.97) and mechanical ventilation exceeding 7 days (OR 1.83; 95% CI, 1.04–3.23) remained significant independent predictors. Conclusions: PES was common among pediatric cardiac patients and was independently associated with lower body weight at extubation and prolonged mechanical ventilation. Recognition of children at higher risk may support targeted preventive strategies and improve post-extubation outcomes.
SN - 1471-2431
ER -