Nasogastric and Endotracheal Tubes as Risk Factors for Sinusitis in Critically Ill Children: A Retrospective Case-control Study

Abstract

Introduction: Unknown fever in critically ill patients could be caused by occult sinusitis, which may also be related to healthcare interventions. The aim of this study was to uncover the correlation between a tube in the upper airways and children’s susceptibility to sinusitis. Methods: We retrieved data retrospectively and evaluated radiological images for the presence of nasogastric (NG) and endotracheal (ET) tubes, as well as any findings of sinusitis or nasopharyngeal (NF) secretions. We also recorded the intervals between the images. Results: The study included 65 patients with a total of 162 images. The results showed a significant increase in the occurrence of sinusitis between the first (13/30, 43.3%) and second (20/30, 66.6%) images (p=0.039). The cut-off time for the onset of sinusitis was found to be 2.5 days [area under the curve: 0.50, 95% confidence interval (CI): 0.355-0.646]. There was no significant difference in the occurrence of sinusitis or NF secretion formation between single or double tubes (p=0.389). The presence of an NG or ET tube also did not show a significant relationship with sinusitis. However, the study found that NF secretions were present in 52% of images with an ET tube [p=0.004, odds ratio (OR): 6.21, 95% CI: 0.001-0.003] and 84% with an NG tube (p=0.003, OR: 6.9, 95% CI: 0.001-0.003). Conclusion: The placement of NG and ET tubes, separately or combined, can raise the likelihood of sinusitis development in critically ill children due to reduced clearance of NF secretions.

Keywords

• sinusitis
• nasogastric tube
• endotracheal tube
• critical care