2013
Effect of timing of tracheostomy on changes in bacterial colonisation of the lower respiratory tract in burned children
LIPOVÝ, Břetislav; Pavel BRYCHTA; Hana ŘIHOVÁ; I. SUCHANEK; M. HANSLIANOVA et al.Základní údaje
Originální název
Effect of timing of tracheostomy on changes in bacterial colonisation of the lower respiratory tract in burned children
Autoři
LIPOVÝ, Břetislav; Pavel BRYCHTA; Hana ŘIHOVÁ; I. SUCHANEK; M. HANSLIANOVA; Michaela CVANOVÁ; Zuzana CHALOUPKOVÁ; Nora GREGOROVÁ a Iva HUFOVÁ
Vydání
Burns, OXFORD, ELSEVIER SCI LTD, 2013, 0305-4179
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30200 3.2 Clinical medicine
Stát vydavatele
Velká Británie a Severní Irsko
Utajení
není předmětem státního či obchodního tajemství
Impakt faktor
Impact factor: 1.836
Označené pro přenos do RIV
Ano
Kód RIV
RIV/00216224:14110/13:00071793
Organizační jednotka
Lékařská fakulta
UT WoS
Klíčová slova anglicky
Burns; Tracheostomy; Bacteria
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 4. 2. 2014 15:27, Soňa Böhmová
Anotace
V originále
Objective: The study aims to evaluate the impact of early and late tracheostomy on microbiological changes in the airways in severely burned children. Materials and methods: Early tracheostomy is sometimes performed within 3 days after the start of mechanical ventilation regular microbiological surveillance of the respiratory tract was done in all patients. From each sputum, tracheobronchial aspirate and bronchoalveolar lavage (BAL), a microscopic slide was made and the material was seeded in a culture medium. The standard culture media used for the growth of respiratory pathogens are blood agar, McConkey agar, VL agar and chocolate agar. The obtained values were statistically analysed. Results: In the observed period, a total of 68 children underwent mechanical ventilation in our department. A total of 31 (45.59%) children had undergone surgical tracheostomy (18 patients with early tracheostomy and 13 patients with late tracheostomy). The most common bacterium isolated from the lower respiratory tract in patients with early and late tracheostomy was Acinetobacter baumannii (31.53% resp. 44.30% of all bacterial strains). In patients with early tracheostomy, the ratio of G+/G- during the 6-7th day of mechanical ventilation was 1.29:1 and during the 8-10th day, 1:1.43. In patients with late tracheostomy the G+/G- ratio was 1:2.25 and during the 8-10th day, 1:2.25. There was not any statistically significant deviation in the G+/G- ratio in patients with early and late tracheostomy in any of the monitored periods. Conclusion: The main reasons for performing early tracheostomy are: extent, localisatian and depth of the burn. Difficult weaning in an uncooperative patient, failure of extubation with subsequent reintubation and other complications may be an indication for late tracheostomy. The study confirms that the use of appropriately indicated early tracheostomy provides a microbiological benefit for burned children.