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首页> 外文期刊>Pediatric critical care medicine: a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies >Uncuffed endotracheal tubes should not be used in seriously burned children.
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Uncuffed endotracheal tubes should not be used in seriously burned children.

机译：严重烧伤的儿童不应使用带气管的带气管导管。

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摘要

OBJECTIVE: To document a complication associated with placement of uncuffed endotracheal tubes in seriously burned children. DESIGN: Retrospective review. SETTING: Verified pediatric burn center. PATIENTS/SUBJECTS: Acutely burned children requiring urgent replacement of uncuffed endotracheal tubes with cuffed endotracheal tubes over a 5-yr period. INTERVENTIONS: In all children, the reason behind the need for urgent tube change was uncontrollable air leak, despite properly sized uncuffed endotracheal tubes, as respiratory failure progressed and compliance worsened. RESULTS:: These two girls and three boys had an average age of 2.2 +/- 1.0 yrs, burn size of 41% +/- 6.1% of the body surface, and subsequently required mechanical ventilation for an average of 23.6 +/- 6.3 days. Urgent tube change was required an average of 64.2 +/- 43.8 hrs after arrival in the burn unit (87.6 +/- 49.4 hrs after injury). Although successful in all children, massive facial edema rendered tube change potentially dangerous. The intervention would not have been necessary if cuffed endotracheal tubes had been placed initially. All children went on to survive their injury, without further tube change or tracheostomy. CONCLUSION: If children are critically burned and expected to require more than transient mechanical ventilatory support, low-pressure cuffed endotracheal tubes should be placed, regardless of the child's age.
机译：目的：记录严重烧伤儿童与未充气气管插管放置有关的并发症。设计：回顾性审查。地点：经过验证的儿科烧伤中心。患者/受试者：严重烧伤的儿童，需要在5年内用带气管的气管导管紧急更换无气管的气管导管。干预措施：在所有儿童中，由于呼吸衰竭的进展和顺应性的恶化，尽管适当大小的无气管气管插管，但仍需紧急换管的原因是无法控制的漏气。结果：这两个女孩和三个男孩的平均年龄为2.2 +/- 1.0岁，烧伤面积为体表的41％+/- 6.1％，随后平均需要进行机械通气，平均为23.6 +/- 6.3岁天。到达烧伤装置后，平均需要紧急换管64.2 +/- 43.8小时（受伤后为87.6 +/- 49.4小时）。尽管在所有儿童中均成功，但面部广泛的水肿使管更换变得潜在危险。如果最初放置了袖带气管导管，则无需干预。所有的孩子都继续生存，没有进一步的换管或气管切开术。结论：如果儿童被严重烧伤，并且预期需要的不仅仅是短暂的机械通气支持，则应放置低压袖带式气管插管，无论其年龄如何。

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