意外的气管管切除术:使用NSQIP-P数据库的儿科患者的风险因素和并发症
Jacob Heninger1, Arkadeep Ghosh1, Matthew Rowland1
1Department of Pediatric Anesthesiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University Chicago, IL, USA.
International journal of pediatric otorhinolaryngology
|December 2, 2024
概括
儿童的意外气管管切除术 (ATD) 是一个严重的风险,发生在1.8%的病例中. 女性性别和气道异常增加了ATD风险,突出了针对性预防策略的需要.
科学领域:
- 儿科手术 儿科手术
- 关键护理医学 关键护理医学
- 患者安全 患者安全
背景情况:
- 意外气管切除术 (ATD) 是儿科患者的一个危急,危及生命的事件.
- 在儿童中导致ATD的因素仍然在很大程度上未被确定.
- 这项研究旨在使用国家数据集确定儿科患者中ATD的发病率和相关因素.
研究的目的:
- 为了确定小儿病患者意外气管管切除术 (ATD) 的发生率.
- 确定与ATD相关的人口,并发症和手术内因素.
- 调查ATD与不良术后结果之间的关联.
主要方法:
- 分析国家外科质量改善儿科 (NSQIP-P) 数据集从2012-2021年.
- 包括接受气管切除术的儿科患者 (CPT 31600或31601).
- 利用多变量后勤回归和倾向得分匹配来识别ATD风险因素和结果.
主要成果:
- 在5229名儿科气管切除术患者中,ATD发生在1.8%的患者中,其中42%发生在手术后48小时内.
- 女性性别和结构性肺/气道异常独立地与ATD相关.
- ATD与意外重新手术和肺炎的风险增加有关.
结论:
- 意外脱是儿科气管切除术后的一个重大并发症.
- 识别高风险患者和ATD的时间允许采取有针对性的预防措施.
- 由于其严重的相关后果,预防ATD至关重要.
相关概念视频
Tracheostomy Decannulation
112
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...
112
Tracheostomy: Procedure and Tubes
401
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...
401
Tracheostomy Care I: Pre-procedural Steps
134
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:
134
Oxygen Delivering System III: Tracheostomy and T-piece
467
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...
467
Tracheostomy Suctioning I: Pre-Procedural Steps
423
Tracheostomy suctioning is a critical procedure healthcare professionals perform to maintain a patent airway in patients with a tracheostomy tube. This procedure is necessary when secretions accumulate in the airway, causing respiratory distress. Here is a step-wise procedural guide for performing tracheostomy suctioning using an open system.
Equipment Required
First, gather all necessary equipment: a sterile suction catheter, a sterile disposable container, sterile gloves, a towel or...
Equipment Required
First, gather all necessary equipment: a sterile suction catheter, a sterile disposable container, sterile gloves, a towel or...
423
Tracheostomy Suctioning II: Procedure
166
Tracheostomy suctioning is a vital nursing procedure that involves removing secretions from the tracheostomy tube to maintain airway patency and prevent respiratory complications. Nurses need to understand the proper technique for tracheostomy suctioning to ensure patient safety and comfort. In this guide, we will outline the step-by-step process for performing tracheostomy suctioning, including preparing the sterile field, donning personal protective equipment (PPE), lubricating and connecting...
166


