Page N E, Giehl M, Luke S
Department of Pediatrics, State University of New York Health Science Center, Syracuse University Hospital, USA.
AACN Clin Issues. 1998 Feb;9(1):25-35. doi: 10.1097/00044067-199802000-00003.
The acutely ill child requiring intubation is at risk for complications at three crucial points: during the intubation procedure, in the first few hours or days after intubation, and during long-term endotracheal tube (ETT) placement. Consideration must be given to the anatomic and physiologic differences between children and adults that place children at risk for acute respiratory failure and that present difficulties in providing respiratory support. Each potential complication must be understood in terms of cause, assessment, prevention, and intervention. The method of securing the ETT can decrease tube displacement, trauma to the airway, and breakdown of the skin. Intra- and interhospital transport presents more considerations in maintaining ETT placement and physiologic stability of the patient. Prevention of intubation complications in children can reduce length of stay, decrease cost of care, minimize length of time for family separation, decrease potential disabilities and prevent death in the critically ill child who requires intubation.
插管过程中、插管后的最初数小时或数天内，以及长期放置气管内导管（ETT）期间。必须考虑儿童与成人在解剖学和生理学上的差异，这些差异使儿童有发生急性呼吸衰竭的风险，并在提供呼吸支持方面存在困难。必须从病因、评估、预防和干预等方面理解每一种潜在并发症。固定ETT的方法可减少导管移位、气道创伤和皮肤破损。院内和院际转运在维持ETT位置和患者生理稳定性方面需要更多考虑。预防儿童插管并发症可缩短住院时间、降低护理成本、最大限度减少家庭分离时间、减少潜在残疾，并防止需要插管的危重病患儿死亡。
