Hertzog J H, Siegel L B, Hauser G J, Dalton H J
Department of Pediatrics, Georgetown University Medical Center, Washington, DC 20007-2197, USA.
Chest. 1999 Jul;116(1):260-3. doi: 10.1378/chest.116.1.260.
Tracheal extubation after laryngotracheal reconstruction in children may be complicated by postoperative tracheal edema and pulmonary dysfunction. The replacement of a tracheal tube in this situation may exacerbate the existing injury to the tracheal mucosa, complicating subsequent attempts at tracheal extubation. We present two cases where noninvasive positive-pressure ventilation was employed to treat partial airway obstruction and respiratory failure in two children following laryngotracheal reconstruction. Noninvasive positive-pressure ventilation served as a bridge between mechanical ventilation via a tracheal tube and spontaneous breathing, providing airway stenting and ventilatory support while tracheal edema and pulmonary dysfunction were resolved. Under appropriate conditions, noninvasive positive-pressure ventilation may be useful in the management of these patients.
儿童喉气管重建术后气管拔管可能会因术后气管水肿和肺功能障碍而变得复杂。在这种情况下更换气管导管可能会加重已有的气管黏膜损伤，使后续的气管拔管尝试变得更加复杂。我们报告两例在儿童喉气管重建术后采用无创正压通气治疗部分气道梗阻和呼吸衰竭的病例。无创正压通气在通过气管导管进行机械通气和自主呼吸之间起到了桥梁作用，在气管水肿和肺功能障碍得到缓解的同时提供气道支架和通气支持。在适当的条件下，无创正压通气可能对这些患者的管理有用。
