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Korean J Crit Care Med > Volume 2(2); 1987 > Article
Korean Journal of Critical Care Medicine 1987;2(2): 117-123.
장기간 기관내삽관후 발생한 합병증의 임상 경험
길혜금, 신양식, 고신옥
연세대학교 의과대학 마취과학교실
Clinical Experience of Complications from Prolonged Endotracheal Intubation
Hae Keum Kil, Yang Sik Shin, Shin Ok Koh
Department of Anesthesiology Yonsei University college of Medicine Seoul Korea
ABSTRACT
Prolonged intubation of the trachea in the treatment of acute respiratory failure has become commonplace in the Intensive Care Unite during the last decade. We defined prolonged endotracheal intubation as cases in which endotracheal intubation is required more than 7 days, and then experiences 202 cases out of 5,856 Intensive Care Unit patients from March 1981 to February l986 in Severance Hospital, Yonsei Medical Complex were evaluated. The results were as follows" 1) The number of patients were 202 cases in total. and male and females were 136 and 69 cases. The teen-age groups was most common, 69 cases(33.7%) and forties was 35 cases (17. 3%). 2) The patients of internal medicine department was the most common, 23,3% and pediatric and neurosurgical department followed in order. 3) The most common causes of acute respiratory failure is central nervous system disorders and ARDS (Adult Respiratory Distress Syndrome). 4) Average stay in Intensive Care Unit was 23.5 day, from 3 to days. Ninty-nine cases (49%) were improved and the remainder (103 cases) were expired. 5) Orotracheal intubation is performed in l44 cases (71.4%) and tracheostomy was done in 4S cases, among them, in 39 cases oro-and nasotracheal intubation was changed to trac-heostomy after 12 days. 6) Oro-or nasotracheal tube was changed 2.5 times every 6.3 days. Mean intubation and tracheostomy days was 15.5 and 76.3 days. 7) Ventilatory support was maintained in 199 cases and 12.1 days in endotraeheal intubation patients and 29.1 days in tracheostomy patients. 8) Complication developed in 29 cases awang them 10 cases were in oro- or nasotracheal intubation patients and 19 cases were in tracheoatomy patients. Horsenss, laryngeal edema, and sore throat were developed in 3.2 and 1 cases, respectively, in orotracheal intubation patients and granu1oma, tracheal stenosis. trachea1 ulceration. and vocal cord palsy were developed in 9,5,2, and 2 cases, respectively, in tracheostomy patents. From the above results. it can be concluded that tracheal complication was serious for the patients who required required ventilatory support under prolonged endotracheal intubation. So we must try to prevent the complication which develop after prolonged endotracheal intubation and maintaining the patients with cardio-respiratory support.
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