Department of Pediatric Emergency and Critical Care Medicine, Japanese Red Cross Kumamoto Hospital, 2-1-1 Ngamineminami Higashi-ku, Kumamoto, 861-8520, Japan.
Department of Quality and Safety in Healthcare, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan.
Sci Rep. 2024 Feb 12;14(1):3475. doi: 10.1038/s41598-024-54247-x.
We aimed to investigate whether ventilator support time influences the occurrence of dysphagia in pediatric trauma patients. This case-series study was conducted in a single pediatric emergency and critical care center from April 2012 to March 2022. Trauma patients aged < 16 years who underwent tracheal intubation were divided into two groups based on the occurrence of dysphagia within 72 h after extubation, and their data were analyzed. Tracheal intubation was performed in 75 pediatric trauma patients, and 53 of them were included in the analysis. A total of 22 patients had post-extubation dysphagia and head trauma. The dysphagia group tended to have more severe head injuries (Abbreviated Injury Scale (AIS) 4 [4-5] vs. 4 [0-4]; p < 0.05), a longer ventilator support time (7 days [4-11] vs. 1 day [1-2.5]; p < 0.05), and a longer length of hospital stay (27 days [18.0-40.3] vs. 11 days [10.0-21.0]; p < 0.05). Severe head trauma and a long duration of tracheal intubation may be risk factors for dysphagia in pediatric trauma patients. Therefore, early recognition of these risk factors could assist in treatment planning for speech-language pathologist intervention and nutritional routes of administration.
本研究旨在探讨呼吸机支持时间是否会影响儿科创伤患者发生吞咽困难。这项病例系列研究于 2012 年 4 月至 2022 年 3 月在一家儿科急诊和重症监护中心进行。根据拔管后 72 小时内是否发生吞咽困难，将接受气管插管的＜16 岁创伤患者分为两组，并对其数据进行分析。在 75 例儿科创伤患者中进行了气管插管，其中 53 例纳入分析。共有 22 例患者出现拔管后吞咽困难和头部创伤。吞咽困难组患者的头部损伤更严重（损伤严重程度评分（Abbreviated Injury Scale，AIS）4-5 分比 4-0 分；p＜0.05），呼吸机支持时间更长（7 天[4-11]比 1 天[1-2.5]；p＜0.05），住院时间更长（27 天[18.0-40.3]比 11 天[10.0-21.0]；p＜0.05）。严重的头部创伤和长时间的气管插管可能是儿科创伤患者发生吞咽困难的危险因素。因此，早期识别这些危险因素有助于制定治疗计划，以便进行言语治疗师干预和选择营养途径。
