The influence of peak airway pressure and oxygen requirement on infant tracheostomy

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• 作者：James W. Schroeder Jr.^a ; ^{jschroeder@childrensmemorial.org} ; John S. Schneider^b ; David L. Walner^b
• 关键词：Tracheostomy ; Pediatric ; Peak airway pressure
• 刊名：International Journal of Pediatric Otorhinolaryngology
• 出版年：2012
• 期刊代码：135_01655876
• 类别：med
• 出版时间：June, 2012
• 卷：76
• 期：6
• 页码：869-872
• 文件大小：196 K

摘要

Objective

To determine if and how the preoperative peak airway pressure and oxygen requirement of an infant (less than 6 months of age) who requires mechanical ventilation influences the physician's decision to perform a tracheostomy on that infant.

Study design

Nationwide survey.

Subjects

Pediatric Otolaryngologists.

Methods

A web-based survey was developed and sent to all members of the American Society of Pediatric Otolaryngology.

Results

150 of the 348 surveys were returned (43%). The majority of respondents do not consider the patient's requirement for elevated peak airway pressure (PAP) or the patient's requirement for a high percentage of oxygen as a contraindication to performing a tracheostomy in that patient (54.7 and 72.1%respectively). The presence of preoperative high PAP influenced 68.2%of respondents to consider using a cuffed tracheostomy tube. In the immediate postoperative period, the most common complication resulting in significant morbidity or mortality was mucous plugging, and the majority of respondents attributed postoperative morbidity and mortality to preoperative pulmonary comorbidity.

Conclusions

Preoperative PAP and the patient's oxygen requirement do not influence the surveyed otolaryngologists鈥?decision whether or not to perform a tracheostomy in the infant population. However, PAP do influence whether or not a cuffed tracheostomy tube is used.