气管切除术对烧伤吸入伤害的结果
Samuel Ruiz1, Salomon Puyana2, Mark McKenney1,3
1Department of Surgery, HCA Florida - Kendall Hospital, Miami, Florida.
Eplasty
|September 4, 2023
概括
炎症患者的气管切除术并没有影响死亡率,但导致住院时间延长和肺炎风险增加. 需要进一步的研究来澄清气管切除术对肺损伤的影响.
科学领域:
- 烧伤护理 烧伤护理
- 关键护理医学 关键护理医学
- 呼吸系统药物 呼吸系统药物
背景情况:
- 对于需要长时间机械通风的患者,可以考虑进行气管切除术.
- 燃烧吸入伤害在气道管理和呼吸支持方面存在独特的挑战.
研究的目的:
- 为了评估气管切除术在患有需要机械通风的烧伤吸入伤害的患者的结果.
- 为了比较经过气管切除术和未经过气管切除术的患者之间的死亡率,停留时间和与呼吸机相关的肺炎 (VAP) 率.
主要方法:
- 从2011年到2019年对烧伤患者的回顾性审查.
- 纳入标准:有记录的吸入伤害,机械通风时间≥24小时,总体表面积<15%.
- 患者分为气管切除术 (第一组) 和无气管切除术 (第二组) 的分层;分析的结果包括死亡率,ICU和住院时间,呼吸机日和VAP发生率.
主要成果:
- 33名患者符合标准 (10名在第一组,23名在第二组).
- 气管切除组 (组1) 显示显著延长了ICU停留时间 (23.8 vs. 3.16天),住院时间 (28.4 vs. 5.26天) 和呼吸机日 (20.8 vs. 2.5天).
- 死亡率没有显著差异;然而,VAP发病率在气管切除组显著高于VAP发病率.
结论:
- 在这个队列中,气管切除术与长时间住院和重症监护室住院以及增加VAP率有关.
- 该研究无法最终将气管切除术的影响与潜在肺损伤的严重程度分开.
- 燃烧吸入伤害患者中气管切除术的最佳时间和影响需要进一步调查.
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