Clinical application of flexible bronchoscopy and neck ultrasound in percutaneous dilatational tracheotomy in infants / 中华实用儿科临床杂志

ABSTRACT

Objective:To investigate the value of flexible bronchoscopy and neck ultrasound in percutaneous dilatational tracheotomy (PDT) in infants.Methods:The clinical data of 24 patients, who underwent flexible bronchoscopy and neck ultrasound assisted PDT in the Center for Respiratory Intervention, Children′s Hospital Affiliated to Shandong University from December 2018 to May 2021, were retrospectively analyzed.Of the 24 cases, 12 were male and 12 female.The male to female ratio was 1∶1.The age range was 21 days to 2 years (median 5 months). The median mass was 5.8 kg.During the PDT, neck ultrasound was used to assess the thyroid position and vascular shape of vessels.After determining the puncture approach and marking the tracheostomy site, the PDT was performed under the guidance of flexible bronchoscopy.Results:Before surgery, 19 children (79.2%) had received continuous endotracheal intubation mechanical ventilation support, 2 children (8.3%) were treated by intermittent endotracheal intubation mechanical ventilation support therapy, and 3 children (12.5%) were supported by the non-invasive ventilator.There were 9 cases (37.5%) of congenital upper respiratory tract malformation, 8 cases (33.3%) of bilateral vocal cord paralysis, 3 cases (12.5%) of upper respiratory tract neoplastic diseases, 2 cases (8.3%) of surgical evacuation difficulties, and 2 cases (8.3%) of neuromuscular disease.All 24 patients successfully completed the operation within 30 min, with bleeding volume less than 5 mL and no intraoperative complications.Conclusions:Flexible bronchoscopy and neck ultrasound can assist in the successful PDT in infants, significantly reduce the difficulty and improve the safety of PDT.