Davies Patrick, Gates Simon, Grundy Richard
Paediatric Critical Care Unit, Nottingham University Hospitals NHS Trust, Nottingham Children's Hospital, Nottingham, UK.
School of Medicine, University of Nottingham, Nottingham, UK.
BMJ Case Rep. 2018 Sep 5;2018:bcr-2017-224040. doi: 10.1136/bcr-2017-224040.
A 2-year-old boy with severe pulmonary Langerhans cell histiocytosis presented in extreme respiratory failure. He was intubated and ventilated. Despite maximal support, he deteriorated and needed extremely high ventilator pressures. An electrical impedance tomography monitor was used to inform management. This is a monitoring technique which is not used in children due to the lack of suitable interface devices and a lack of randomised clinical evidence. Despite technical difficulties, a good signal was achieved. This informed management and enabled the selection of a suitable ventilator strategy, facilitating weaning. Electrical impedance tomography is a viable technology for use in paediatric critical respiratory failure. This is a non-invasive and safe technology which adds individual patient information which is not available through any other modalities. We urge equipment manufacturers to develop belts which will allow routine application of this life-saving technology in children.
一名患有严重肺部朗格汉斯细胞组织细胞增多症的2岁男孩出现了极度呼吸衰竭。他接受了插管和通气治疗。尽管给予了最大程度的支持，他的病情仍在恶化，需要极高的通气压力。使用了电阻抗断层扫描监测仪来指导治疗。由于缺乏合适的接口设备和随机临床证据，这种监测技术在儿童中未被使用。尽管存在技术困难，但仍获得了良好的信号。这为治疗提供了依据，并使得能够选择合适的通气策略，促进了撤机。电阻抗断层扫描是一种可用于小儿严重呼吸衰竭的可行技术。这是一种非侵入性且安全的技术，能提供通过其他任何方式都无法获得的个体患者信息。我们敦促设备制造商开发能使这项救生技术在儿童中常规应用的腰带。
