在小儿气管切除术安置中与早期死亡率相关的因素:一项回顾性队列研究
Roee Noy1,2, Danny Eytan3,4, Jacob T Cohen5,3
1Department of Otolaryngology-Head and Neck Surgery, Rambam Health Care Campus, Haifa, Israel. roeenoy@gmail.com.
European journal of pediatrics
|November 12, 2024
概括
儿科气管切除术后的早期死亡率与早产,年轻,严重的健康状况 (如心力衰竭) 和延迟的手术有关. 了解这些因素对于更好的患者护理和风险沟通至关重要.
科学领域:
- 儿科手术 儿科手术
- 关键护理医学 关键护理医学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
背景情况:
- 由于新生儿和儿科重症监护的进步,儿童中气管切除术的患病率有所增加.
- 尽管如此,接受气管切除术的儿童的死亡率仍然很高,其中很大一部分在同一住院期间死亡.
研究的目的:
- 确定与接受气管切除术的儿童早期死亡率和并发症相关的因素.
- 为了为临床决策提供有关气管切除术时间和患者风险评估的信息.
主要方法:
- 在高等推中心进行的回顾性研究,包括在2012年至2023年期间接受气管切除术的256名儿童.
- 使用多变量后勤回归分析来确定与30天死亡率和气管切除术相关并发症相关的因素.
主要成果:
- 30天死亡率为10.9% (28名儿童).
- 与30天死亡率相关的因素包括早产,年龄<12个月,ASA类4,气管管切除术晚位 (>14天),先天性心脏病,心力衰竭和呼吸系统依赖.
- 在30天内死亡的儿童患术后并发症的比率明显更高 (85.7%vs30.3%),较小的出血最常见.
结论:
- 许多因素增加了儿童气管切除术后早期死亡的风险.
- 这些发现对于优化危急儿童气管切除术时间至关重要.
- 加强与护理人员关于程序风险的沟通至关重要.
相关概念视频
Tracheostomy Care I: Pre-procedural Steps
135
A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
Required Equipment
The equipment necessary for tracheostomy care includes:
Required Equipment
The equipment necessary for tracheostomy care includes:
135
Tracheostomy: Procedure and Tubes
415
A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
415
Oxygen Delivering System III: Tracheostomy and T-piece
513
Oxygen delivery is critical in clinical care, especially for patients with respiratory disorders or those undergoing surgical procedures. Various systems, such as tracheostomy and the T-piece, deliver oxygen to the lungs, ensuring adequate arterial oxygenation.
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
513
Tracheostomy Decannulation
115
Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
115
Tracheostomy Care II: Procedure
119
Tracheostomy care is an essential nursing skill that involves cleaning and maintaining a tracheostomy tube to prevent infection and other complications. Here's a step-by-step guide explaining each procedure with its rationale. Note that disposable gloves are to be worn at all times and changed as often as needed to maintain a sterile work environment, and to protect both patient and healthcare worker.
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask...
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask...
119
Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
361
Oxygen therapy is a pivotal aspect of medical care, particularly for patients with respiratory ailments. Two prominent oxygen-delivering systems include the Venturi mask and the transtracheal oxygen catheter.
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
361


