Clinician opinions on nasal versus oral intubation in infants with BPD: A multicenter survey.
Clinician opinions on nasal versus oral intubation in infants with BPD: A multicenter survey.
复制标题
临床医生对 BPD 婴儿鼻插管与口腔插管的看法：一项多中心调查。
DOI：
10.1002/ppul.26653
复制
发表时间：
2023
影响因子：
3.1
通讯作者：
Jensen,ErikA
中科院分区：
文献类型：
--
作者：
Vitale,JessicaL;DeMauro,SaraB;Gibbs,Kathleen;Kielt,MatthewJ;Nelin,LeifD;Jensen,ErikA
在患有支气管肺发育不良（BPD）的早产儿中，经后36周（PMA）后的有创机械通气与生长失败和发育障碍的风险增加相关1，2。暴露于镇静药物和对患者活动进行身体约束以尽量减少气管插管（ETT）移动和移位可能导致这些缺陷。对呼吸机依赖的BPD婴儿实施气管造口术与生长发育改善、麻醉剂暴露减少以及更多地参与物理和职业治疗相关2。增加人工气道稳定性的替代性非手术策略可能产生类似的益处。来自儿科研究的有限可用数据表明，鼻插管而不是口腔插管可能会减少短期机械通气过程中的计划外拔管3，4。接受长期有创通气的BPD婴儿的最佳插管途径尚不清楚。为了提供关于这一主题的初步数据，我们调查了临床医生对BPD婴儿经鼻插管与经口插管的风险和益处的看法。
Invasive mechanical ventilation after 36 weeks’ postmenstrual age (PMA) in preterm infants with bronchopulmonary dysplasia (BPD) is associated with increased risks for growth failure and developmental disability1, 2. Exposure to sedating medications and physical restraint of patient activity to minimize endotracheal tube (ETT) movement and dislodgement may contribute to these deficits. Placement of a tracheostomy in ventilatordependent infants with BPD has been associated with improved growth, reduced narcotic exposure, and greater participation in physical and occupational therapy2. Alternative, nonsurgical strategies that increase stability of the artificial airway may produce similar benefits. Limited available data from pediatric studies suggest that nasal rather than oral intubation may reduce unplanned extubations during short courses of mechanical ventilation3, 4. The optimal route of intubation in infants with BPD receiving prolonged invasive ventilation is unknown. To provide initial data on this topic, we examined clinicians’ opinions on the risks and benefits of nasal versus oral intubation in infants with BPD.