与反复非计划性拔管相关的短期并发症和长期病态。
Short-term complications and long-term morbidities associated with repeated unplanned extubations.
机构信息
Division of Neonatology, Nationwide Children's Hospital, Columbus, OH, USA.
Center for Perinatal Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
出版信息
J Perinatol. 2021 Mar;41(3):562-570. doi: 10.1038/s41372-021-00927-9. Epub 2021 Feb 5.
OBJECTIVE
To describe characteristics associated with repeated unplanned extubations, short-term complications and outcomes, and longer-term morbidities including acquired subglottic stenosis.
STUDY DESIGN
Cohort study including neonates admitted to a tertiary care neonatal intensive care unit who experienced an unplanned extubation in a 5-year period.
RESULTS
We reviewed 588 events involving 300 patients. Ten percent had airway trauma with reintubation, 42% required ≥2 reintubation attempts, and 39% led to increased baseline oxygen. Increased odds of repeated events were seen in patients with bronchopulmonary dysplasia and were associated with higher rates of tracheostomy and longer length of stay. The 9% of patients diagnosed with acquired subglottic stenosis had more unplanned extubations, higher rates of airway trauma and tracheitis, and were an older gestational age at birth.
CONCLUSION
Unplanned extubations lead to short- and long-term morbidities. Certain patient characteristics are associated with increased odds of repeated events and the development of acquired subglottic stenosis.
目的
描述与反复非计划性拔管、短期并发症和结局以及包括获得性声门下狭窄在内的长期并发症相关的特征。
研究设计
对在 5 年内经历非计划性拔管的入住三级护理新生儿重症监护病房的新生儿进行队列研究。
结果
我们回顾了 588 个事件，涉及 300 名患者。10%的患者有气道创伤并需要重新插管，42%的患者需要≥2 次重新插管尝试，39%的患者需要增加基础氧气。支气管肺发育不良的患者反复发生事件的几率更高，与气管切开术和住院时间延长的发生率更高相关。9%被诊断为获得性声门下狭窄的患者非计划性拔管次数更多，气道创伤和气管炎的发生率更高，出生时胎龄更大。
结论
非计划性拔管会导致短期和长期的并发症。某些患者特征与反复发生事件和获得性声门下狭窄的发展有关。
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