PDF(Pubmed)
Abstract：
Tracheostomized children have higher mortality compared to adults due to smaller airway anatomy and greater medical complexity and are at high risk for life-threatening complications. Following new tracheostomy placement, caregivers are required to successfully complete extensive training before discharge home. Training for tracheostomy emergencies such as tube obstruction and accidental decannulation is challenging without real-life, hands-on experience, but simulation training has shown promising effects on improving caregiver knowledge and comfort in preparing for emergency situations. Readmissions and emergency department visits are common following discharge, with many due to respiratory illness. Inhaled antibiotics are frequently prescribed to treat bacterial respiratory infection. However, guidelines for standardized management of tracheostomy-related respiratory illness are not available. Although standardized decannulation protocols are utilized, evidence-based guidelines are lacking, and the role of routine polysomnogram prior to decannulation is unresolved. Several knowledge gaps in management of pediatric tracheostomy present the opportunity for future research to improve patient outcomes.
摘要：
与成人相比，气管造口术的儿童由于气道解剖结构较小和医疗复杂性较大而具有较高的死亡率，并且面临危及生命的并发症的高风险。在新的气管造口术后，护理人员需要在出院回家前成功完成广泛的培训。在没有现实生活的情况下，对气管造口术紧急情况（如导管阻塞和意外拔管）的培训具有挑战性，亲身体验,但是模拟训练在改善护理人员知识和为紧急情况做准备时的舒适度方面显示出了有希望的效果。出院后再入院和急诊就诊很常见,许多人是因为呼吸道疾病。吸入抗生素通常用于治疗细菌性呼吸道感染。然而,目前尚无气管造口术相关呼吸系统疾病的标准化管理指南.尽管使用了标准化的去管协议，缺乏循证指南，常规多导睡眠图在拔管前的作用尚未解决。小儿气管造口术管理方面的一些知识空白为未来的研究提供了机会，以改善患者的预后。
