Outcomes of tracheostomy in the neonatal intensive care unit: is there an optimal time?
Outcomes of tracheostomy in the neonatal intensive care unit: is there an optimal time?
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DOI：
10.3109/14767058.2013.860438
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发表时间：
2014-08-01
影响因子：
1.8
通讯作者：
Natarajan, Girija
中科院分区：
文献类型：
--
作者：
Rane, Sharayu;Bathula, Sambasiva;Natarajan, Girija
目的：比较出生后初次住院期间接受早期和晚期气管造口术的婴儿的短期结局，并确定气管造口术时机和结局之间的关联（如果有）。研究设计：对在单一地点初次住院期间接受气管造口术的婴儿进行回顾性图表审查。结果：我们队列（n = 127）的中位（范围）胎龄为 28（23-42）周，出生体重为 988 (390-4030) g.气管造口适应症包括气道病变（47%）、支气管肺发育不良（25%）、两者（22%）和其他（6%）。气管切开术时的中位经后年龄 (PMA) 为 45 (35-75) 周。 27 名（21%）婴儿死亡，65 名（51%）婴儿接受机械通气。 42 名 (33%) 婴儿出院时存在 G 管。接受早期气管切开术（= 45 周 PMA）的婴儿（n = 61）组。晚期气管切开组的死亡（29.5% vs 14%）、家庭通气（41% vs 21%）和 G 管（44% vs 14%）的发生率明显更高。在双变量回归中，调整胎龄和呼吸支持后，结果与气管切开术时机并不独立相关。结论：在出生后首次住院期间接受气管切开术的婴儿中，21% 死亡。根据调整后的分析，气管切开术时机与结果并不独立相关。
Objective: To compare short-term outcomes of infants who underwent early versus late tracheostomy during their initial hospitalization after birth and determine the association, if any, between tracheostomy timing and outcomes.Study design: Retrospective chart review of infants who underwent a tracheostomy during their initial hospitalization at a single site.Results: The median (range) gestational age of our cohort (n = 127) was 28 (23-42) weeks and birth weight was 988 (390-4030) g. Tracheostomy indications included airway lesions (47%), bronchopulmonary dysplasia (25%), both (22%) and others (6%). Median postmenstrual age (PMA) at tracheostomy was 45 (35-75) weeks. Death occurred in 27 (21%) infants and 65 (51%) infants were mechanically ventilated. G-tube was present at discharge in 42 (33%) infants. Infants who underwent early tracheostomy (= 45 weeks PMA) (n = 61) group. Death (29.5% versus 14%), home ventilation (41% versus 21%) and G tube (44% versus 14%) were significantly more frequent in the late tracheostomy group. On bivariate regression, outcomes were not independently associated with tracheostomy timing, after adjustment for gestational age and respiratory support.Conclusions: Of infants who underwent tracheostomy during the initial hospitalization after birth, 21% died. On adjusted analysis, tracheostomy timing was not independently associated with outcomes.