Alibrahim Ibrahim J, Kabbani Mohamad S, Abu-Sulaiman Riyadh, Al-Akhfash Ali, Mazrou Khalid A
Pediatric Cardiology Division, King AbdulAziz Medical City, Riyadh.
J Saudi Heart Assoc. 2012 Jul;24(3):163-8. doi: 10.1016/j.jsha.2012.01.003. Epub 2012 Feb 1.
To investigate the incidence, timing indications and outcome of tracheotomy in children who underwent cardiac surgeries.
All pediatric cardiac patients (under 14 years of age) who underwent cardiac surgeries and required tracheotomy from November 2000 to November 2010 were reviewed. The data were collected and reviewed retrospectively.
Sixteen children underwent tracheotomy after cardiac surgery. Fifteen of these cases had surgery for congenital heart disease, and one had surgery for an acquired rheumatic mitral valve disease. The mean ± SEMs of the durations of ventilation before and after tracheotomy were 60.4 ± 9.8 and 14.5 ± 4.79 days respectively (P value 0.0002). The means ± SEM of the lengths of ICU stay before and after tracheotomy were 63.31 ± 10.15 and 22 ± 5.4 days respectively (P value 0.0012). After the tracheotomy 12/16 patients (75%) were weaned from their ventilators and 10/16 were discharged from the PCICU. Six patients were discharged from the hospital and 3 were successfully decannulated. The overall survival rate was 9/16 (56%).
Tracheostomy shortens the duration of mechanical ventilation and facilitates discharge from the ICU. The mortality of tracheotomy patients is still significant but is mainly related to the primary cardiac disease.
探讨接受心脏手术患儿气管切开术的发生率、时机、指征及预后。
回顾2000年11月至2010年11月期间接受心脏手术且需要气管切开术的所有儿科心脏病患者（14岁以下）。数据收集后进行回顾性分析。
16例患儿在心脏手术后接受了气管切开术。其中15例为先天性心脏病手术，1例为后天性风湿性二尖瓣疾病手术。气管切开术前、后通气时间的均值±标准误分别为60.4±9.8天和14.5±4.79天（P值0.0002）。气管切开术前、后重症监护病房（ICU）住院时间的均值±标准误分别为63.31±10.15天和22±5.4天（P值0.0012）。气管切开术后，16例患者中有12例（75%）脱机，16例中有10例从儿科重症监护病房（PCICU）出院。6例患者出院，3例成功拔管。总生存率为9/16（56%）。
气管切开术可缩短机械通气时间并促进从ICU出院。气管切开术患者的死亡率仍然较高，但主要与原发性心脏病有关。
