小児気管切開の検討および気管ボタン状カニューレの使用について

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Tracheotomy in children has been associated with many complications compared to that in aduls in the medical literature. But the serious complications of long-term translaryngeal intubation for ventilatory support such as laryngeal injury are well known. Fourteen children less than 3 years of age who had tracheotomies for prolonged ventilator support from January 1988 to April 1991 are reviewed. Ten patients (71.4%) were under 1 year of age. The mean time of translaryngeal intubation prior to tracheotomy was 229 days. All patients had difficulties in weaning from mechanical ventilation before tracheotomy. All had an improvement with tracheotomy and eleven patients had been weaned from mechanical ventilation. Seven were discharged from the hospital to home care. None had early complication and 3 patients (21.4%) developed 6 late complications in tracheotomy. None of the complications of tracheotomy was serious. Subglottic stenosis by prolonged translarygeal intubation developed in four patients. The managements for these problems were difficult. The tracheotomy tube was replaced by the cuff button-like cannula in seven children who had improvements of respiratory state. Two of these 7 were decannu-lated safely. We conclude that tracheotomy can be performed safely, and for patients who require long-term intubation, we would decide to perform an early tracheotomy. The cuff button-like cannula is very effective for home care and decannulation.
日本小児外科学会の論文
1992-08-20

小児気管切開の検討および気管ボタン状カニューレの使用について

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