Emergency Medicine
UMEM Educational Pearls

Title: Adverse effects of pediatric intubation.

Category: Pediatrics

Keywords: Complications, intubation, pediatric (PubMed Search)

Posted: 3/20/2026 by Jenny Guyther, MD (Updated: 3/20/2026)

This was review of 24 studies across 21 years that aimed to look at the complications associated with pediatric intubation in the hospital.  The article also includes a list of all the articles with brief conclusions from each study for those interested. 

Among a combined 7135 patients, there was an 84.7% overall success rate with a 30.1% rate of complication.  There was a 69.8% first pass success rate.  Desaturations < 90% was the most common complication followed by mainstem intubation.  Studies also noted cardiac arrhythmia (55/3858 patients), hypotension (121/4536 patients) and cardiac arrest in 105/4836 patients).  Other adverse events included esophageal intubation, surgical airway management and airway trauma.

Indications for intubation from most to least common are: neurologic, respiratory, trauma, cardiac arrest, sepsis, shock, cardiac failure and intoxication.

References

Alsabri M, Kamal I, Al-Tawil M, Bahbah EI, Elshanbary AA, Zaazouee MS, Zamarud A, Binsaeedu AS, Shahbaz MU, Chhetri J. Adverse events in pediatric orotracheal intubation in the pediatric emergency department: systematic review and meta-analysis. Pediatr Res. 2025 Jun 20. doi: 10.1038/s41390-025-04142-6. Epub ahead of print. PMID: 40542093.


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