Tracheostomies in Burn Patients
| Autor: | Roger W. Yurt, Cleon W. Goodwin, Michael R. Madden, William G. Jones, Jerome L. Finkelstein |
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| Rok vydání: | 1989 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Tracheoesophageal fistula Tracheostomy Tracheotomy Intubation Intratracheal medicine Humans Intubation business.industry Middle Aged respiratory system medicine.disease Surgery Tracheal Stenosis Respiratory failure Anesthesia Sputum Female Airway management medicine.symptom Burns business Airway Tracheoarterial Fistula Burns Inhalation Tracheoesophageal Fistula Research Article |
| Zdroj: | Annals of Surgery. 209:471-474 |
| ISSN: | 0003-4932 |
| Popis: | The use of tracheostomies in burned patients with inhalation injuries is now reserved for specific indications rather than as prophylactic airway management. A 5-year burn center experience with tracheostomies used in this fashion is presented. Ninety-nine tracheostomies were performed in 3246 patients who had indications of prolonged respiratory failure or acute loss of airway. Although colonization of the sputum was universal, neither rates of pulmonary sepsis nor mortality were significantly increased in patients who underwent tracheostomies. Twenty-eight patients developed late upper airway sequelae, including tracheal stenosis (TS), tracheoesophageal fistula (TEF), and tracheoarterial fistula (TAF). Duration of intubation correlated only with development of TAF, whereas patients in whom TEF developed were significantly older and more likely to have evidence of tracheal necrosis at the time of tracheostomy. The pathogenesis of upper airway sequelae in these patients as divergent responses to the combined insults of inhalation injury, infection, and intubation is considered. |
| Databáze: | OpenAIRE |
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