Can Fulya Kamit, Anıl Ayşe Berna, Anıl Murat, Gümüşsoy Murat, Çitlenbik Hale, Kandoğan Tolga, Zengin Neslihan
Unit of Pediatric Intensive Care, İzmir Tepecik Training and Research and Hospital, İzmir, Turkey.
Unit of Pediatric Intensive Care, Katip Çelebi Univercity School of Medicine, İzmir, Turkey.
Turk Pediatri Ars. 2018 Sep 1;53(3):177-184. doi: 10.5152/TurkPediatriArs.2018.6586. eCollection 2018 Sep.
We aimed to describe which clinical characteristics were associated with the outcome of tracheostomy in our tertiary care pediatric intensive care unit.
This was a retrospective review of medical records of pediatric patients who underwent tracheostomy in our Pediatric Intensive Care unit from 2008 to 2014 in Turkey.
Sixty-three patients were included the study. The median age of patients was 11 (range, 1-195) months. Twenty-five (39.7%) patients were female. The tracheostomy rate was 8.5% over a six-year period. Forty-nine (77.7%) patients were able to be discharged and sent home. The decannulation rate was 12.6% (n=8). The indications for tracheostomy were upper airway obstruction (n=9) and prolonged mechanical ventilation (n=54). The median intubation period before tracheostomy was 32 (range, 1-122) days and the median duration of pediatric intensive care unit stay after tracheostomy was 37 days. A total of 21 (52.5%) patients were weaned off mechanical ventilation. The rate of successful weaning from mechanical ventilation was higher in patients with upper airway obstruction than in those in the prolonged mechanical ventilation group (p=0.021). The complication rate was 25.3% in the pediatric intensive care unit and 11.1% at home.
Tracheostomy seems safe and improves pediatric patients' outcomes. The most important factor that affects the prognosis of children who underwent tracheostomy is the indication for tracheostomy. The outcomes are always better if the tracheostomy has been performed because of upper airway obstruction. Performing tracheostomy helps weaning from and off ventilator support and finally the discharge of patients with prolonged mechanical ventilation from the pediatric intensive care unit setting.
我们旨在描述在我们的三级护理儿科重症监护病房中，哪些临床特征与气管切开术的结果相关。
这是一项对2008年至2014年在土耳其我们的儿科重症监护病房接受气管切开术的儿科患者病历的回顾性研究。
63例患者纳入研究。患者的中位年龄为11（范围1 - 195）个月。25例（39.7%）为女性。六年期间气管切开率为8.5%。49例（77.7%）患者能够出院回家。拔管率为12.6%（n = 8）。气管切开的指征为上呼吸道梗阻（n = 9）和机械通气时间延长（n = 54）。气管切开术前的中位插管时间为32（范围1 - 122）天，气管切开术后在儿科重症监护病房的中位住院时间为37天。共有21例（52.5%）患者脱机。上呼吸道梗阻患者的机械通气成功脱机率高于机械通气时间延长组患者（p = 0.021）。儿科重症监护病房的并发症发生率为25.3%，在家中的并发症发生率为11.1%。
气管切开术似乎是安全的，并且改善了儿科患者的预后。影响接受气管切开术儿童预后的最重要因素是气管切开的指征。如果因上呼吸道梗阻而行气管切开术，结果总是更好。进行气管切开术有助于脱机以及最终使机械通气时间延长的患者从儿科重症监护病房出院。
