COMPLICATIONS OF OROTRACHEAL INTUBATION IN PEDIATRICS

Abstract

Introduction: Orotracheal intubation is an essential procedure in pediatrics to ensure open airways and adequate ventilation in critical situations. Due to the anatomical and physiological particularities of children, intubation presents unique challenges and is associated with a series of complications that can range from mild to severe. In this context, nursing plays an essential role, contributing from the preparation of the environment and equipment to direct assistance in the procedure and post-intubation care. In addition to technical knowledge, nurses need to be able to identify signs of complications early, perform immediate interventions and promote adequate maintenance of care, minimizing risks and promoting the safety of pediatric patients. This study, therefore, aims to investigate the main complications of orotracheal intubation in children and discuss the importance of nursing in the prevention and management of these complications. Methodology: This study is characterized as a literature review, conducted in the Virtual Health Library (VHL) through the LILACS, SciELO and BDENF databases. The research used the descriptors registered in DeCS: Pediatrics, Intubation and Complications, in order to identify relevant studies. After the initial screening, the articles were subjected to strict inclusion and exclusion criteria. Studies that met the eligibility criteria were selected, including observational, quantitative, qualitative, cohort studies, case reports and experiences, in addition to randomized studies available in full, in Portuguese, published in the last 25 years, which corresponded to the research objective. The exclusion criteria included literature reviews, incomplete studies, duplicates in different databases, monographs, theses and dissertations. The analysis of the results was performed qualitatively, using secondary data from the bibliographic review. Results and discussion: The results identified frequent complications in pediatric orotracheal intubation, such as lack of knowledge of professionals, airway injuries, infections and obstructions, often resulting from factors such as inadequate use of materials and failures in the rapid sequence intubation technique. Nursing stood out in preventing these problems, with interventions such as checking tube positioning, careful suction of secretions, and continuous monitoring of respiratory parameters. In addition, ongoing training of nurses proved essential for early identification of signs of complications and for providing safe, high-quality care. Conclusion: It is concluded that orotracheal intubation in pediatrics, although essential in critical contexts, presents significant challenges due to the anatomical and physiological particularities of pediatric patients. Complications such as airway trauma, edema, laryngospasm, esophageal intubation, and hemodynamic problems are common and can compromise the safety and efficacy of the procedure. Given these risks, the role of nursing in preventing and managing complications becomes fundamental, requiring technical preparation and continuous monitoring to ensure the safety and well-being of children undergoing this intervention.