Impact of tracheotomy on colonization and infection of lower airways in children requiring long-term ventilation: a prospective observational cohort study

Chest
P MorarR van Saene

Abstract

Determination of the following: (1) colonization and infection rates in children requiring long-term ventilation initially via a transtracheal tube and subsequently via a tracheotomy; (2) the number of infection episodes per 1,000 ventilation days, during both types of artificial airways; and (3) routes of colonization/infection of the lower airways, ie, whether the pathogenesis was endogenous (via the oropharynx) or exogenous (via the transtracheal tube or tracheotomy). Observational, cohort, prospective study over 2 1/2 years. Pediatric ICU (PICU), Royal Liverpool Children's National Health Service Trust of Alder Hey, a tertiary referral center. Twenty-two children requiring long-term mechanical ventilation initially transtracheally and subsequently via a tracheotomy. Nil. The lower airways were colonized in 71% of children during transtracheal ventilation; posttracheotomy, this was 95% (p=0.03). Children developed significantly fewer infections following colonization with a microorganism posttracheotomy (8/15 pretracheotomy vs 6/21 posttracheotomy; p=0.013). Throughout the study, there were a total of 17 episodes of infection, all of which were preceded by colonization. Haemophilus influenzae, Staphylococcus aureus, Acinetob...Continue Reading

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Citations

Jan 28, 2009·Intensive Care Medicine·Rebeca PaivaBrigitte Fauroux
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May 23, 2003·American Journal of Otolaryngology·Weerachai TantinikornMargaretha L Casselbrant
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Jun 1, 2005·Intensive Care Medicine·Brigitte FaurouxMarie-Paule Vazquez
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Aug 28, 2004·The Annals of Otology, Rhinology, and Laryngology·Kenneth A GellerMaie A R St John
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Oct 1, 2019·The Pediatric Infectious Disease Journal·Joerg Grosse-OnnebrinkHeymut Omran
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Mar 14, 2021·International Journal of Pediatric Otorhinolaryngology·Emine AtagSedat Oktem

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