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1.
Thorac Surg Clin ; 30(1): 83-90, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31761287

RESUMO

Nonintubated anesthesia is feasible and might be associated with shorter surgery time and shorter hospitalization for tracheal/carinal resection and reconstruction. Only case reports and a few small retrospective series study were conducted to evaluate nonintubated anesthesia for tracheal/carinal resection and reconstruction; no randomized control trials exist. Further exploration should focus on selection of optimal candidates and prospective validation.


Assuntos
Anestesia/métodos , Doenças da Traqueia/cirurgia , Traqueotomia/métodos , Humanos , Procedimentos Cirúrgicos Reconstrutivos/métodos
2.
Thorac Surg Clin ; 30(1): 91-99, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31761288

RESUMO

The article describes an anesthetic management strategy for resection of the cervical trachea due to benign stenosis without using an endotracheal tube. The strategy includes: (1) insertion of an airway stent in the stenotic area, (2) insertion of a supraglottic airway device (SGAD), and (3) advancing a jet ventilation catheter through the SGAD. The stent is removed during surgery together with the resected part of the trachea. The technique of nonintubated tracheal resection allows the surgeon to work most comfortably and helps the anesthesiologist properly maintain the patient's vital functions in the operating room.


Assuntos
Manuseio das Vias Aéreas , Anestesia/métodos , Estenose Traqueal/cirurgia , Traqueotomia , Manuseio das Vias Aéreas/instrumentação , Manuseio das Vias Aéreas/métodos , Humanos , Stents , Traqueotomia/instrumentação , Traqueotomia/métodos
3.
Artigo em Chinês | MEDLINE | ID: mdl-31623052

RESUMO

Objective:To explore the application of percutaneous dilatation tracheotomy for patients with difficult airway. Method:Retrospectively analyzed the clinical data of percutaneous dilatation tracheotomy in difficult airway patients, summarized the difficulties, technical points and advantages. Result:Collecting the clinical data of 28 patients with difficult airway, 20 cases were head and neck tumor recurrence after surgery, radiation and chemotherapy, 3 cases were cervical hematoma, 2 cases were laryngeal neoplasm with heart failure, 2 cases were mandatory spondylitis, and 1 case was airway stenosis. The difficult points for tracheotomy were unable to lie down, neck stiffness, displacement of the trachea, coagulation disorder, unclear neck structure, etc. All patients accepted percutaneous dilatation tracheotomy, including cone and forceps dilatation tracheotomy, with none complication. Conclusion:Percutaneous dilatation tracheotomy was a safe, rapid and minimally invasive surgical method for patients with difficult airway requiring tracheotomy, and could be used as the preferred solution.


Assuntos
Traqueotomia/métodos , Dilatação , Humanos , Recidiva Local de Neoplasia , Traqueia , Traqueostomia
5.
Eur Arch Otorhinolaryngol ; 276(11): 3173-3177, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31489494

RESUMO

PURPOSE: In acute epiglottitis (AE) or acute supraglottitis (AS), the management of the airway is crucial. We hypothesized that tracheotomized patients recover faster than intubated patients do. METHODS: We retrospectively reviewed all adult AE and AS patients, who underwent intubation or tracheotomy between 2007 and 2018 in a tertiary care center. Patient demographics, treatment, and complications were analyzed. RESULTS: The cohort comprised 42 patients. The airway was secured with intubation in 50% and with tracheotomy in 50%. All intubated patients (n = 21) and three tracheotomized patients were treated in the intensive care unit (p < 0.0001). Procedure-related complications were encountered in three intubated and eight tracheotomized patients (p = 0.892). Median overall treatment cost was 11.547 € and 5.856 € in the intubated and tracheotomized patient groups, respectively (p < 0.001). The median duration of sick leave after discharge from hospital was 13 days in the tracheotomy group and 7 days in the intubation group (p = 0.097). CONCLUSION: Tracheotomy resulted in a less expensive management in securing the airway in AE or AS, but tracheotomized patients had a trend towards more complications and longer sick leaves compared to intubated patients. LEVEL OF EVIDENCE: 2b.


Assuntos
Epiglotite , Intubação Intratraqueal , Assistência ao Paciente , Complicações Pós-Operatórias , Supraglotite , Traqueotomia , Doença Aguda , Adulto , Custos e Análise de Custo , Epiglotite/fisiopatologia , Epiglotite/cirurgia , Feminino , Finlândia , Humanos , Intubação Intratraqueal/efeitos adversos , Intubação Intratraqueal/economia , Intubação Intratraqueal/métodos , Masculino , Pessoa de Meia-Idade , Assistência ao Paciente/economia , Assistência ao Paciente/métodos , Assistência ao Paciente/estatística & dados numéricos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Supraglotite/fisiopatologia , Supraglotite/cirurgia , Traqueotomia/efeitos adversos , Traqueotomia/economia , Traqueotomia/métodos , Resultado do Tratamento
6.
Br J Anaesth ; 123(5): 696-703, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31451190

RESUMO

BACKGROUND: The 'cannot intubate cannot oxygenate' (CICO) emergency requires urgent front of neck airway (FONA) access to prevent death. In cases reported to the 4th National Audit Project, the most successful FONA was a surgical technique, almost all of which were performed by surgeons. Subsequently, UK guidelines adopted surgical cricothyroidotomy as the preferred emergency surgical FONA technique. Despite regular skills-based training, anaesthetists may still be unwilling to perform an emergency surgical FONA. Consultant anaesthetists, head and neck surgeons, and general surgeons were compared in a high-fidelity simulated emergency. We hypothesised that head and neck surgeons would successfully execute emergency surgical FONA faster than anaesthetists and general surgeons. METHODS: We recruited 15 consultants from each specialty (total of 45) at a single tertiary care hospital in the UK. All agreed to participate in an in situ high-fidelity simulation of an 'anaesthetic emergency'. Participants were not told in advance that this would be a CICO scenario. RESULTS: There were no significant differences in total time to successful ventilation between anaesthetists, head and neck surgeons and general surgeons (median 86 vs 98 vs 126 s, respectively, P=0.078). Anaesthetists completed the emergency surgical FONA procedure significantly faster than general surgeons (median 50 vs 86 s, P=0.018). Despite this strong performance, qualitative data suggested some anaesthetists still believed 'surgeons' best placed to perform emergency surgical FONA in a genuine CICO situation. CONCLUSION: Anaesthetists regularly trained in emergency surgical FONA function at levels comparable with head and neck surgeons and should feel empowered to lead this procedure in the event of a CICO emergency.


Assuntos
Manuseio das Vias Aéreas/normas , Competência Clínica , Cartilagem Cricoide/cirurgia , Traqueotomia/normas , Manuseio das Vias Aéreas/métodos , Anestesiologia/normas , Contraindicações de Procedimentos , Emergências , Inglaterra , Cirurgia Geral/normas , Humanos , Intubação Intratraqueal/efeitos adversos , Simulação de Paciente , Distribuição Aleatória , Cartilagem Tireóidea/cirurgia , Traqueotomia/métodos
7.
Lakartidningen ; 1162019 May 15.
Artigo em Sueco | MEDLINE | ID: mdl-31192393

RESUMO

The main, but not sole, indication for an Ex-utero Intrapartum Treatment (EXIT) delivery is an airway obstruction due to either laryngeal atresia or tumors in the head and neck region. Here we present our Institution's experience with eleven cases: three teratomas, four lymphatic malformations, two laryngeal atresias and two dermoid cysts. The EXIT procedure was used to secure the fetal airway while maintaining uteroplacental gas exchange and fetal hemodynamic stability through the umbilical circulation. Five fetuses required tracheostomy. Only one fetal death occurred due to extensive growth of a teratoma preventing us from establishing an airway. No other fetal or major maternal complication occurred. The EXIT procedure is a complex procedure and these rare cases should be referred to a center with a dedicated and experienced multidisciplinary team.


Assuntos
Obstrução das Vias Respiratórias , Histerotomia/métodos , Laparotomia/métodos , Adulto , Obstrução das Vias Respiratórias/congênito , Obstrução das Vias Respiratórias/cirurgia , Cesárea , Malformação Adenomatoide Cística Congênita do Pulmão/cirurgia , Feminino , Neoplasias de Cabeça e Pescoço/congênito , Neoplasias de Cabeça e Pescoço/cirurgia , Hospitais Universitários , Humanos , Recém-Nascido , Intubação Intratraqueal/métodos , Doenças da Laringe/congênito , Doenças da Laringe/cirurgia , Laringe/anormalidades , Laringe/cirurgia , Anormalidades Linfáticas/cirurgia , Equipe de Assistência ao Paciente , Gravidez , Resultado da Gravidez , Diagnóstico Pré-Natal , Estudos Retrospectivos , Região Sacrococcígea/patologia , Região Sacrococcígea/cirurgia , Suécia , Teratoma/congênito , Teratoma/cirurgia , Traqueotomia/métodos
8.
Anaesthesia ; 74(9): 1153-1157, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31165475

RESUMO

Emergency front-of-neck access to achieve a percutaneous airway can be a life-saving intervention, but there is debate about the preferred technique. This prospective, observational study was designed to compare the two most common emergency surgical airway techniques in a wet lab simulation using an ovine model. Forty-three doctors participated. After providing standardised reading, a lecture and dry lab benchtop training, participants progressed to a high-fidelity wet lab simulation. Participants entered an operating theatre where a 'cannot intubate, cannot oxygenate' situation had been declared and were directed to perform emergency front-of-neck access: first with a cannula technique (14-gauge cannula insertion with ventilation using a Rapid-O2® cricothyroidotomy insufflation device); and subsequently, a scalpel-bougie technique (surgical incision, bougie insertion into trachea and then tracheal tube passed over bougie, with ventilation using a self-inflating bag). The primary end-point was time from declaration of 'cannot intubate, cannot oxygenate' to delivery of oxygen via a correctly placed percutaneous device. If a cannula or tracheal tube was not placed within 240 s, the attempt was marked as a failure. There was one failure for the cannula approach and 15 for the scalpel-bougie technique (OR 0.07 (95%CI 0.00-0.43); p <0.001). Median (IQR [range]) time to oxygenation, if successful, was 65 (57-78 [28-160]) s for the cannula approach and 90 (74-115 [40-265]) s for the scalpel-bougie technique (p=0.005). In this ovine model, emergency front-of-neck access using a cannula had a lower chance of failure and (when successful) shorter time to first oxygen delivery compared with a scalpel-bougie technique.


Assuntos
Manuseio das Vias Aéreas/métodos , Cânula , Cartilagem Cricoide/cirurgia , Traqueotomia/instrumentação , Traqueotomia/métodos , Animais , Serviços Médicos de Emergência , Humanos , Modelos Animais , Estudos Prospectivos , Ovinos
9.
BMC Neurol ; 19(1): 79, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-31043155

RESUMO

OBJECTIVE: Patients with severe brain injury is usual at high risk of extubation failure, despite of those with no/minor primary respiratory problem, majority of them still needs long term respiratory support and has severe pulmonary complications. This retrospective study aimed to compare the effect of noninvasive ventilation (NIV) and tracheotomy on the prognosis in critically ill mechanically ventilated neurosurgical patients. METHODS: This is a single center, retrospective observe cohort study. Postoperative patients with brain injury consecutively admitted to ICU from November 1st, 2015 through February 28th, 2017, who had received invasive mechanical ventilation more than 48 h were screened, those who received NIV or tracheotomy procedure, meanwhile with Glasgow Coma Scale (GCS) score between 8 and 13 points before using NIV or undergoing tracheotomy, were retrospectively included in this study. The demographic data and clinical main outcomes such as ICU and hospital mortality, time of mechanical ventilation, length of ICU and hospital were collected. The primary outcome was the incidence of postoperative pulmonary infection between two groups. RESULTS: 77 patients were included in this study. 33 patients received NIV, and 44 patients received tracheotomy through the ICU duration. The incidence of postoperative pulmonary infection in NIV group was significantly lower than that in tracheotomy group (54.5% VS 84.1%, P < 0.05), Application of NIV was associated with shorter duration of invasive mechanical ventilation ([median 123.0 h VS 195.0 h, P < 0.05). Moreover, GCS score at ICU discharge, as well as the difference of GCS score between at admission to ICU and ICU discharge were also better than the tracheotomy group (P < 0.001). CONCLUSION: Compared with tracheotomy, use of NIV after extubation in critically ill mechanically ventilated neurosurgical patients may be associated with lower incidence of postoperative pulmonary infection, shorter duration of invasive mechanical ventilation and better improvement in brain function. Further studies need to verify the effect of NIV in this kind of patients.


Assuntos
Ventilação não Invasiva/métodos , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/etiologia , Traqueotomia/métodos , Adulto , Idoso , Extubação , Lesões Encefálicas/terapia , Estudos de Coortes , Estado Terminal , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Ventilação não Invasiva/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Traqueotomia/efeitos adversos
10.
J Int Med Res ; 47(6): 2764-2767, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31109227

RESUMO

We herein present a case involving a 78-year-old patient who had aspirated a laryngotracheal foreign body 3 days prior to hospital admission. The patient had severe congenital intellectual disability; however, no agitation, suffocation, or death occurred despite almost complete laryngeal obstruction. The laryngotracheal foreign body was removed by tracheotomy and suspended microlaryngoscopy.


Assuntos
Corpos Estranhos/complicações , Deficiência Intelectual , Laringoestenose/prevenção & controle , Traqueotomia/métodos , Idoso , Animais , Osso e Ossos , Galinhas , Corpos Estranhos/cirurgia , Humanos , Laringoscopia , Laringoestenose/etiologia , Masculino
11.
Ann Ital Chir ; 90: 10-13, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30737363

RESUMO

AIM: To evaluate the effects of surgical and percutaneous tracheotomy on thyroid hormones. MATERIAL AND METHOD: Sixty patients with respiratory problems who underwent surgical tracheotomy and percutaneous tracheotomy between December 2012 and December 2016 were divided into 2 groups. FT3, FT4, thyroglobulin and TSH levels of the groups were statistically evaluated preoperatively and postoperatively. RESULTS: The effects of surgical and percutaneous tracheotomy on free thyroxin (FT4), serum thyroglobulin (TG) and thyroid stimulating hormone (TSH) levels were found to be statistically significant. Although free triiodothyronine (FT3) slightly elevated in both groups, it was not statistically significant. DISCUSSION: Today, percutaneous tracheotomy (PCT) and conventional surgical tracheotomy (CT) have been widely used in intensive care units on patients who are expected to be connected to mechanical ventilation for a long time. Because of the anatomy of the surgical site, tracheotomy may cause damage to the adjacent thyroid gland and tracheal rings CONCLUSION: Surgeons should keep in mind that serum thyroid hormone levels may increase postoperatively. Particularly the patients with cardiac rhythm problems should be followed after surgical and percutaneous tracheotomy due to the systemic effects of thyroid hormones. KEY WORDS: Tracheotomy, Thyroid hormones.


Assuntos
Hormônios Tireóideos/sangue , Traqueotomia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
12.
Zhongguo Fei Ai Za Zhi ; 22(1): 1-5, 2019 Jan 20.
Artigo em Chinês | MEDLINE | ID: mdl-30674386

RESUMO

Currently, enhanced recovery after surgery (ERAS) has been widely accepted by surgery and anesthesiology all over the world, and applied in colorectal surgery, gynecology, liver surgery, breast surgery, urology and spinal surgery. But ERAS are rarely used in the field of interventional bronchoscopy. In recent years, more and more researchers have begun to explore the application of ERAS in bronchoscopic interventional therapy. This article discussed that preoperative preparation, anesthesia, intraoperative operation, postoperative observation and other aspects can influence interventional bronchoscopy.
.


Assuntos
Recuperação de Função Fisiológica , Neoplasias da Traqueia/fisiopatologia , Neoplasias da Traqueia/cirurgia , Traqueotomia/métodos , Anestesia/métodos , Broncoscopia/métodos , Humanos , Tempo de Internação , Assistência Perioperatória/métodos
13.
A A Pract ; 12(3): 77-78, 2019 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-30074516

RESUMO

Ventilation or oxygenation can be difficult or even impossible in cases of upper airway obstruction. In this case report, we used a helium/oxygen mixture administered via noninvasive positive-pressure ventilation to perform an urgent tracheotomy under local anesthesia on a patient presenting upper airway compression. It improved his comfort and his stridor, facilitating supine positioning. This case describes another potential indication of the helium/oxygen mixture in noninvasive ventilation.


Assuntos
Obstrução das Vias Respiratórias/cirurgia , Ventilação não Invasiva/instrumentação , Traqueotomia/métodos , Idoso , Obstrução das Vias Respiratórias/diagnóstico por imagem , Anestesia Local , Hélio/administração & dosagem , Humanos , Masculino , Oxigênio/administração & dosagem , Decúbito Dorsal , Tomografia Computadorizada por Raios X
14.
Ann R Coll Surg Engl ; 101(1): e23-e25, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30322284

RESUMO

We describe a rare case of cervical necrotising fasciitis caused by mastoiditis and Bezold's abscess. This case was complicated by a tracheostomy delaying wound healing. A novel strategy to repair the tracheotomy defect using Permacol™, an acellular porcine dermal substitute, and a local muscle flap not previously reported in the literature is described to allow the use of negative pressure wound therapy dressing. This technique may be employed in similar applications for non-healing tracheotomy wounds.


Assuntos
Abscesso/complicações , Fasciite Necrosante/etiologia , Pescoço , Tratamento de Ferimentos com Pressão Negativa/métodos , Abscesso/cirurgia , Materiais Biocompatíveis/uso terapêutico , Colágeno/uso terapêutico , Fasciite Necrosante/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Pescoço/cirurgia , Infecção da Ferida Cirúrgica/cirurgia , Infecção da Ferida Cirúrgica/terapia , Traqueotomia/efeitos adversos , Traqueotomia/métodos
15.
Heart Lung ; 48(1): 46-54, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30336945

RESUMO

BACKGROUND: The optimal timing of tracheotomy in critically ill ventilated patients remains controversial. OBJECTIVES: The objective of this meta-analysis was to assess tracheotomy timing for critically ill ventilated patients and determine the outcomes' reliability. METHODS: We searched PubMed, Embase, and the Cochrane Library for randomized controlled trials. RESULTS: Compared with late tracheotomy, early tracheotomy presented a lower incidence of ventilator-associated pneumonia (VAP), shorter duration of mechanical ventilation (MV), and shorter intensive care unit (ICU) stay. However, trial sequential analysis (TSA), a kind of cumulative meta-analysis, indicated that the evidence was unreliable and inconclusive. CONCLUSIONS: The Findings suggest that early tracheotomy seems to be associated with a lower incidence of VAP, shorter duration of MV, shorter duration of sedation, and shorter ICU stay. However, the apparent benefits revealed in traditional meta-analysis contrast with the post-TSA results. More fully powered, randomized controlled trials focused on the outcomes of tracheotomy are highly warranted.


Assuntos
Cuidados Críticos/métodos , Estado Terminal/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Respiração Artificial/métodos , Traqueotomia/métodos , Humanos
16.
Laryngoscope ; 129(4): 818-822, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30593661

RESUMO

OBJECTIVES: 1) Evaluate success rates for adults undergoing cervical slide tracheoplasty. 2) Examine complication rates of slide tracheoplasty in adults. METHODS: A retrospective cohort of adults > 21 years of age undergoing cervical slide tracheoplasty for tracheal stenosis between October 2011 and August 2017 was reviewed. Comorbidities, stenosis grade, etiology of stenosis, primary versus revision surgery, complications, and number of adjunct endoscopic procedures required postoperatively were evaluated. RESULTS: Nineteen patients (63% female) underwent cervical slide tracheoplasty during the study period (median age 30 years, range 21-70). The most common etiology of stenosis was iatrogenic (68%), followed by congenital etiologies (26%). Fifty-eight percent of patients had undergone a previous open airway procedure. Thirty-nine percent were tracheostomy-dependent prior to surgery, and the remainder had severe exercise intolerance. Sixty-three percent were successfully extubated on the operating room table at the end of the procedure. Six (32%) patients experienced surgical complications, including one anastomotic dehiscence, three neck abscesses requiring incision and drainage (I&D), and replacement of adjunctive airway device in two patients. Seventy percent of the patients required ≥ 1 endoscopic dilation in the first 12 months following surgery, with a median of one (range 1-8) procedure. At most recent follow-up (median 8 months, range 4-64 months), 18 of 19 (95%) of patients had minimal airway symptoms without need for tracheostomy. The one patient who was not decannulated expired of a presumed cardiac event prior to decannulation. CONCLUSION: Cervical slide tracheoplasty is an excellent reconstructive option for adult patients with tracheal stenosis, including those with history of previous airway reconstruction. LEVEL OF EVIDENCE: 4 Laryngoscope, 129:818-822, 2019.


Assuntos
Laringoestenose/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Estenose Traqueal/cirurgia , Traqueostomia/métodos , Traqueotomia/métodos , Adulto , Idoso , Feminino , Seguimentos , Humanos , Laringoestenose/etiologia , Masculino , Pessoa de Meia-Idade , Pescoço/cirurgia , Estudos Retrospectivos , Traqueia/cirurgia , Estenose Traqueal/etiologia , Resultado do Tratamento , Adulto Jovem
17.
Laryngoscope ; 129(4): 812-817, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30582158

RESUMO

Fibrodysplasia ossificans progressiva (FOP) is a rare disorder that causes heterotopic bone formation leading to chest wall and spinal deformities. This case describes an 11-year-old female with FOP who presented in respiratory failure necessitating two emergent fiberoptic nasotracheal intubations. The patient had severe trismus, rotary flexion of the neck, and distortion of the airway. A three-dimensional printed model based off of a computed tomography reconstruction was created for an in situ simulation before the true procedure. The surgery and trach change were both uneventful. We propose that with careful preoperative planning, tracheotomy can be an appropriate option for FOP patients. Laryngoscope, 129:812-817, 2019.


Assuntos
Simulação por Computador , Miosite Ossificante/cirurgia , Impressão Tridimensional , Tomografia Computadorizada por Raios X/métodos , Traqueotomia/métodos , Criança , Feminino , Humanos
18.
Int J Pediatr Otorhinolaryngol ; 116: 192-195, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30554697

RESUMO

OBJECTIVES: To compare the rates of skin-related complications and accidental decannulation in pediatric patients who received Velcro® ties versus twill ties during the early postoperative period following tracheotomy. The rates of skin-related complications and accidental decannulation in patients with Velcro® ties was hypothesized to differ from those in patients with twill ties. METHODS: Medical records of 109 patients ≤18 years old who underwent elective tracheotomy were reviewed: 70 received twill ties and 39 received Velcro® ties. Patients were followed for the first seven postoperative days. The primary outcome was skin-related complications, which were further categorized into mild (irritation) and severe (breakdown). The secondary outcome was accidental decannulation. Rates of skin-related complication and accidental decannulation were compared across the two groups using chi-square analysis. RESULTS: Skin irritation occurred in 32 patients (45.7%) with twill ties and 10 patients (25.6%) with Velcro®. Skin breakdown occurred in 20 patients (28.6%) with twill ties and 6 patients (15.4%) with Velcro®. There were no accidental decannulation events. The use of Velcro® ties was associated with a decreased rate of skin irritation (OR: 0.41; 95% CI: 0.17-0.97; P = 0.039). CONCLUSIONS: The use of Velcro® ties was associated with a decrease in the rate of skin irritation. There were no accidental decannulation events. These findings support the use of Velcro® ties at the time of pediatric tracheotomy placement.


Assuntos
Extubação/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Dermatopatias/etiologia , Traqueotomia/efeitos adversos , Adolescente , Criança , Pré-Escolar , Desenho de Equipamento/efeitos adversos , Falha de Equipamento/estatística & dados numéricos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Complicações Pós-Operatórias/etiologia , Período Pós-Operatório , Estudos Retrospectivos , Dermatopatias/epidemiologia , Traqueotomia/instrumentação , Traqueotomia/métodos
20.
Zhonghua Shao Shang Za Zhi ; 34(11): 782-785, 2018 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-30481918

RESUMO

Airway edema, stenosis, obstruction and even asphyxia are easy to occur in patients with extensive burn, deep burn of head, face, and neck area, inhalation injuries, etc., which threaten life. Timely tracheotomy and intubation is an important treatment measure, but lack of knowledge and improper handling in some hospitals resulted in airway obstruction. The technique of percutaneous tracheotomy and intubation provides convenience for emergency treatment of critical burns and mass burn. The Burn and Trauma Branch of Chinese Geriatrics Society organized some experts in China to discuss the indications, timing, methods, extubation, and precautions of tracheotomy and intubation for burn patients. The national experts consensus on tracheotomy and intubation for burn patients (2018 version) was written to provide a reference standard for clinical treatment.


Assuntos
Obstrução das Vias Respiratórias/prevenção & controle , Queimaduras/terapia , Consenso , Intubação Intratraqueal/métodos , Guias de Prática Clínica como Assunto/normas , Lesão por Inalação de Fumaça/terapia , Traqueotomia/métodos , Unidades de Queimados , Queimaduras/complicações , China , Humanos
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