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Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
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灵活的光纤支气管镜检查对在体外膜氧化支持的儿童有好处
Pravin Babhalgaonkar1, Gareth Forster2, Ian B Masters3
1Paediatric Intensive Care Unit, Sydney Children's Hospital, Sydney, Australia.
概括
灵活的光纤支气管镜 (FFB) 通过改善诊断和气道清除,帮助儿童进行体外膜氧化 (ECMO). 这种手术具有临床益处,主要并发症的发生率较低,改善了严重呼吸衰竭的护理.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 呼吸系统生理学 呼吸系统生理学
- 干预性肺病学 干预性肺病学
背景情况:
- 灵活纤维光学支气管镜 (FFB) 在增强诊断能力和改善儿科患者需要体外膜氧化 (ECMO) 的肺功能方面表现有前途.
- 对于患有严重呼吸衰竭的儿童来说,ECMO支持至关重要,需要先进的监测和干预技术.
研究的目的:
- 评估通过ECMO支持的儿童进行FFB的临床,放射和微生物学益处.
- 评估FFB在这个脆弱的儿科群体中的安全性和并发症率.
主要方法:
- 进行了一项单一中心的回顾性观察性队列研究.
- 包括在研究期间接受ECMO的儿科患者 (0-18岁) 进行的所有FFB手术.
- 收集的数据包括临床结果,放射学发现,微生物学结果和并发症发生率.
主要成果:
- 在53%的病例中,FFB提供了诊断信息,在62%的病例中,FFB协助了气道清理.
- 患者在FFB后出现了改善的氧化,在6小时和24小时吸入氧气的比例较低.
- 在91%的手术中,放射学发现有所改善或保持稳定,FFB在75%的患者中发现了新的微生物学数据. 严重并发症发生在7.6%的发作中.
结论:
- 灵活的光纤支气管支气管是管理ECMO儿科患者的宝贵辅助工具,提供显著的临床优势.
- 该程序与较低的重大并发症发生率有关,使其成为相对安全的干预措施.
- 建议进行进一步的研究,以制定关于在ECMO患者中使用FFB的共识指南.
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