Knezović I, Vukelić D, Bozinović D
Klinika za infektivne bolesti, Dr. Fran Mihaljevi Medicinskog fakulteta Sveucillista u Zagrebu.
Lijec Vjesn. 1993 Nov-Dec;115(11-12):342-6.
Tracheostomy and endotracheal intubation are complementary methods in the management of acute respiratory failure (ARF). One hundred patients (n = 100) were treated at the Intensive Care Unit for Infants and Children, University Hospital of Infectious Diseases "Dr. Fran Mihaljević" Zagreb, from 1987 to 1991. They mostly suffered from severe infectious diseases in the course of which ARF developed. Endotracheal intubation was performed in 95/100 patients, while tracheostomy was done in 11/100 patients. In the majority of subjects the course of the disease required mechanical ventilation (96%). Complications connected with tracheostomy or intubation developed in 49% of the intubated patients and in 100% of the patients with tracheostomy. 17% mortality rate among our patients was neither the result of tracheostomy or intubation nor of the respiratory support but of the adverse course of the disease and consecutive complications characteristic for newborns and infants. Most of our patients developed ARF as a result of inefficient gas transfer, particularly those suffering from central nervous system infection. Nasotracheal intubation appeared to be the method of choice in the treatment of ARF in infancy and childhood, while tracheostomy is only the supplement of substitute when particular indications are present. In most of our patients (83%) those methods contributed to the positive outcome of ARF treatment.
气管切开术和气管插管术是治疗急性呼吸衰竭（ARF）的互补方法。1987年至1991年期间，萨格勒布“弗兰·米哈列维奇博士”传染病大学医院的婴幼儿重症监护病房对100名患者进行了治疗。他们大多患有严重传染病，在此过程中并发了ARF。100名患者中有95名进行了气管插管，100名患者中有11名进行了气管切开术。大多数患者病程中需要机械通气（96%）。气管插管患者中有49%出现了与气管切开术或插管相关的并发症，气管切开术患者中则100%出现了此类并发症。我们的患者中有17%的死亡率既不是气管切开术或插管的结果，也不是呼吸支持的结果，而是疾病的不良进程以及新生儿和婴儿特有的连续并发症所致。我们的大多数患者因气体交换效率低下而并发ARF，尤其是那些患有中枢神经系统感染的患者。鼻气管插管似乎是婴幼儿期ARF治疗的首选方法，而气管切开术仅在有特定指征时作为补充或替代方法。在我们的大多数患者（83%）中，这些方法有助于ARF治疗取得积极结果。
