Ackerman Kassi, Saley Taylor P, Mushtaq Nasir, Carroll Timothy
Department of Pediatrics, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, United States.
Department of Family and Community Medicine, School of Community Medicine, Oklahoma City, Oklahoma, United States.
J Pediatr Intensive Care. 2019 Jun;8(2):78-82. doi: 10.1055/s-0038-1676117. Epub 2018 Nov 26.
Tracheostomy provides an alternative to long-term intubation in patients with respiratory failure, but there is little guidance for its use in pediatric patients. Our study used provider surveys of pediatric intensive care physicians managing patients intubated longer than 14 days to evaluate accuracy of physician estimates for total intubation time and the impact of medical history and illness category on determining tracheostomy placement. Providers' ability to estimate length of intubation was found to be highly inaccurate. With delayed tracheostomy conferring increased risk and mortality, better recommendations regarding indication and timing of pediatric tracheostomy placement are needed.
气管切开术为呼吸衰竭患者提供了一种替代长期插管的方法，但在儿科患者中的应用指导很少。我们的研究通过对管理插管超过14天的儿科重症监护医师进行调查，以评估医师对总插管时间估计的准确性，以及病史和疾病类别对确定气管切开术时机的影响。结果发现，医护人员对插管时长的估计能力极不准确。由于延迟气管切开术会增加风险和死亡率，因此需要针对儿科气管切开术的适应症和时机给出更好的建议。
