Sofer S, Dagan R
Pediatric Intensive Care Unit, Soroka Medical Center, Beer Sheba.
Harefuah. 1991 Oct;121(7-8):232-5.
Bacterial tracheitis (BT) was found in 10 of 748 children (1.3%) admitted with croup during 1983-1990. 9.9% of all the 748 croup cases seen (74) were admitted to the pediatric intensive care unit (PICU) and 16 of the 74 required intubation. 10 of those intubated (62.5%) were found to have BT and had typical features of croup, including inspiratory stridor, hoarseness and cough. Airway obstruction resulted mainly from accumulated tracheal pus. After endotracheal intubation all required frequent suctioning of thick purulent secretions. In 2 children causative microorganisms were cultured from the blood, and in all 10 from the tracheal pus. All children were given antibiotic therapy but a 7 month-old girl died of secondary complications (respiratory syncytial virus infection, pneumonia and adult respiratory distress syndrome). The others recovered and were discharged from the PICU within 3-14 days. BT should be suspected when tracheal intubation is required in croup. In such cases close monitoring in a PICU and frequent tracheal suctioning after intubation is necessary; antibiotic therapy should be considered.
1983年至1990年期间,748例因喉炎入院的儿童中有10例(1.3%)被诊断为细菌性气管支气管炎(BT)。在所有748例喉炎病例中,9.9%(74例)被收入儿科重症监护病房(PICU),其中74例中有16例需要插管。在这些插管患者中,有10例(62.5%)被发现患有BT,并具有典型的喉炎特征,包括吸气性喘鸣、声音嘶哑和咳嗽。气道阻塞主要是由气管内积脓引起的。气管插管后,所有人都需要频繁抽吸浓稠的脓性分泌物。2名儿童血培养出致病微生物,10名儿童气管脓液培养均有致病微生物。所有儿童均接受了抗生素治疗,但一名7个月大的女孩死于继发并发症(呼吸道合胞病毒感染、肺炎和成人呼吸窘迫综合征)。其他儿童康复并在3至14天内从PICU出院。当喉炎患者需要气管插管时,应怀疑患有BT。在这种情况下,需要在PICU进行密切监测,并在插管后频繁进行气管抽吸;应考虑使用抗生素治疗。