Ricciardello Daniel, Lee Michael, Tran Sonia, Chamberlain Kira, Holland Andrew Ja, Bertinetti Monique
Burns Unit, The Childrens Hospital at Westmead Westmead, NSW, Australia.
Sydney Medical School, Faculty of Medicine and Health, The University of Sydney Sydney, NSW, Australia.
Int J Burns Trauma. 2022 Apr 15;12(2):52-58. eCollection 2022.
The duration of endotracheal intubation is thought to be the most important factor in the development of acquired laryngotracheal stenosis (LTS); however, there is a paucity of studies examining the incidence of LTS in the paediatric burn population. The aim of this study was to determine the incidence of LTS in paediatric burns patients requiring mechanical ventilation to develop guidelines for consideration of a tracheostomy.
A retrospective review of all children treated at The Children's Hospital at Westmead (CHW) Burns Unit (BU) from December 2009 to December 2019 who required intubation for their burn injury.
During the 10-year study period 115 patients required endotracheal intubation after having sustained a burn injury. Of these 11 were excluded. The mean age was 6.2 years (0-16), with the majority of patients being male (65%). The average TBSA was 18.5% with a range of 0.1-70%. Flame was the most common mechanism of burn (n = 59). Burns to the head and/or neck were the most common indication for intubation with the mean duration of intubation 6.1 days (range 0-40). Tracheostomies were performed on two patients (1.9%). LTS was found in two patients (1.9%).
LTS in the paediatric burn population post mechanical ventilation appears to be a rare event. Endotracheal intubation can safely be used as the route of airway access in paediatric burns patients. Based on our experience, a definitive recommendation on the timing of tracheostomy in the paediatric burn patient cannot be made.
气管插管的持续时间被认为是获得性喉气管狭窄（LTS）发生的最重要因素；然而，针对儿科烧伤患者中LTS发生率的研究却很少。本研究的目的是确定需要机械通气的儿科烧伤患者中LTS的发生率，以制定气管切开术的考虑指南。
回顾性分析2009年12月至2019年12月在西梅德儿童医院（CHW）烧伤科（BU）接受治疗且因烧伤需要插管的所有儿童。
在为期10年的研究期间，115例患者在烧伤后需要气管插管。其中11例被排除。平均年龄为6.2岁（0 - 16岁），大多数患者为男性（65%）。平均烧伤总面积为18.5%，范围为0.1% - 70%。火焰是最常见的烧伤原因（n = 59）。头部和/或颈部烧伤是插管最常见的指征，平均插管持续时间为6.1天（范围0 - 40天）。两名患者（1.9%）进行了气管切开术。两名患者（1.9%）发现有LTS。
机械通气后儿科烧伤患者发生LTS似乎是罕见事件。气管插管可安全地用作儿科烧伤患者的气道通路。基于我们的经验，无法对儿科烧伤患者气管切开术的时机给出明确建议。
