在高风险的COVID后患者中开放的呼吸道重建的安全性:一个与案例匹配的对照研究
Benjamin van der Woerd1, Ryan S Ziltzer2, Anna Mathew3
1Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, McMaster University, Hamilton, Ontario, Canada.
American journal of otolaryngology
|December 9, 2024
概括
开放的呼吸道重建是安全有效的治疗气管狭窄症在精心挑选的后COVID-19患者. 结果与非COVID对照结果相比,并发症和未来干预需求最小.
科学领域:
- 肺部病理学 肺部病理学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 胸部外科手术 胸部外科手术
背景情况:
- COVID-19肺炎可能导致气管狭窄,使呼吸道管理复杂化.
- 在COVID后的患者中,先前存在的肺功能障碍引发了人们对呼吸道重建手术风险的担忧.
研究的目的:
- 评估COVID-19后经过精心挑选的气管狭窄症患者的开放呼吸道重建的安全性和结果.
- 为了将这些结果与非COVID-19患者的匹配队列进行比较.
主要方法:
- 追溯病例匹配对照研究,涉及6例COVID后气管狭窄病例和6个匹配对照.
- 匹配标准包括年龄,狭窄的长度和并发症.
- 评估的主要结果是外科手术期间的安全事件和未来呼吸道干预的需要.
主要成果:
- 后COVID和对照组在人口统计和临床因素方面很好地匹配.
- 没有观察到随访持续时间的显著差异.
- 在外科手术期间,没有患者需要重新输管,气管切除术,ICU入院或通风. 一个病例出现过敏反应,一个对照病例出现吸入性肺炎.
- 一个后COVID病例需要非手术干预,但这两组没有患者需要进一步的手术.
结论:
- 开放式呼吸道重建在经过COVID后精心挑选的气管狭窄症患者中显示出出色的安全性和有效性.
- 结果与非COVID对照相似,术后并发症率低,随后干预的必要性最小.
- 这表明开放式气管重建是这种患者群体的可行治疗选择.
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
Endotracheal Tube Extubation
399
Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
399
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: 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
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 Care II: Procedure
118
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...
118


