Yogo Naoki, Sasaki Taeko, Kozumi Masato, Kinoshita Yuya, Muto Yuichiro, Hirai Katsuki, Yoshino Yuichiro
Department of Pediatrics, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan.
Division of Pediatric Emergency and Critical Care, Department of Pediatrics, Japanese Red Cross Kumamoto Hospital, 2-1-1 Nagamineminami, Higashi-ku, Kumamoto, 861-8520, Japan.
Int J Emerg Med. 2022 Sep 5;15(1):42. doi: 10.1186/s12245-022-00451-3.
Airway management in children with severe burns is difficult because of airway edema and prolonged duration of ventilatory management. There is insufficient evidence to suggest that tracheostomy is beneficial for children.
A male child aged 1 year and 4 months was injured when he accidentally fell into a bathtub filled with boiling water. Furthermore, 85% of the burnt area, including the face and neck, consisted of second-degree burns; hence, oral tracheal intubation and resuscitative infusion were required. In this case, the patient was safely switched from oral to nasotracheal intubation using a tracheal tube guide and video laryngoscope, without the use of a bronchoscope, and ventilatory management could be continued for 2 weeks.
Oral to nasal endotracheal tube exchange using a tracheal tube guide and video laryngoscope may be useful not only for pediatric burn patients but also for adult patients who need to be safely switched from oral to nasotracheal intubation.
由于气道水肿和通气管理时间延长，严重烧伤儿童的气道管理具有挑战性。目前尚无充分证据表明气管切开术对儿童有益。
一名1岁4个月大的男童不慎跌入装满沸水的浴缸而受伤。此外，包括面部和颈部在内的85%烧伤面积为二度烧伤；因此，需要进行口腔气管插管和复苏输液。在此病例中，使用气管导管导丝和视频喉镜，在未使用支气管镜的情况下，患者安全地从口腔插管转换为鼻腔插管，并且通气管理可以持续2周。
使用气管导管导丝和视频喉镜进行口腔到鼻腔气管导管交换不仅对小儿烧伤患者有用，而且对需要从口腔插管安全转换为鼻腔插管的成年患者也有用。
