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小儿烧伤患者的气管切开术。

Tracheostomy in pediatric burn patients.

作者信息

Sen Soman, Heather Jonathan, Palmieri Tina, Greenhalgh David

机构信息

Department of Surgery, Division of Burn Surgery, Shriners Hospital for Children Northern California, University of California Davis, Sacramento, CA, United States.

Middlemore Hospital, Department of Plastic Surgery, Auckland, New Zealand.

出版信息

Burns. 2015 Mar;41(2):248-51. doi: 10.1016/j.burns.2014.10.005. Epub 2014 Nov 1.

Abstract

BACKGROUND

Tracheostomy is often performed in the pediatric burn population to establish secure airways. Tracheostomy is safe in this population, but the duration of tracheostomy may be related to age and extent and severity of burn. We hypothesized that burn related factors and not age determine the time to removal of a tracheostomy in pediatric burn patients.

METHODS

A 5-year retrospective review was performed for pediatric burn patients (age ≤18 years) who underwent tracheostomy. Patients were divided into three groups by age (group 1: 0 to ≤2 years, group 2: >2 to ≤12 years, group 3: >12 to ≤18 years). Data collected included: age, total body surface area burn injured (TBSA), gender, mechanism of injury, diagnosis of inhalation injury, mortality, time from injury to admission, time from admission to placement of tracheostomy, time of injury to placement of tracheostomy, duration of tracheostomy, days of mechanical ventilation, and tracheostomy related complications.

RESULTS

45 patients were reviewed. There were no differences in TBSA, length of ICU stay, length of hospital stay, and mortality between the three groups. Additionally, there were no differences in ventilator days and duration of tracheostomy. Multivariate linear regression analysis indicated that TBSA and not age independently increased the duration of tracheostomy.

CONCLUSION

Tracheostomy duration is dependent on the extent of burn in pediatric burn patients.

摘要

背景

小儿烧伤患者常需行气管切开术以建立安全气道。气管切开术在该人群中是安全的,但气管切开术的持续时间可能与年龄、烧伤范围及严重程度有关。我们推测,小儿烧伤患者气管切开术拔除时间取决于烧伤相关因素而非年龄。

方法

对接受气管切开术的小儿烧伤患者(年龄≤18岁)进行了为期5年的回顾性研究。患者按年龄分为三组(第1组:0至≤2岁,第2组:>2至≤12岁,第3组:>12至≤18岁)。收集的数据包括:年龄、烧伤总面积(TBSA)、性别、损伤机制、吸入性损伤诊断、死亡率、受伤至入院时间、入院至气管切开术时间、受伤至气管切开术时间、气管切开术持续时间、机械通气天数及气管切开术相关并发症。

结果

共纳入45例患者。三组患者的TBSA、ICU住院时间、住院时间及死亡率无差异。此外,通气天数和气管切开术持续时间也无差异。多因素线性回归分析表明,独立增加气管切开术持续时间的是TBSA而非年龄。

结论

小儿烧伤患者气管切开术的持续时间取决于烧伤范围。

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