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@article{1163544,
author = {Lipový, Břetislav and Brychta, Pavel and Řihová, Hana and Suchanek, I. and Hanslianova, M. and Cvanová, Michaela and Chaloupková, Zuzana and Gregorová, Nora and Hufová, Iva},
article_location = {OXFORD},
article_number = {2},
doi = {http://dx.doi.org/10.1016/j.burns.2012.05.023},
keywords = {Burns; Tracheostomy; Bacteria},
language = {eng},
issn = {0305-4179},
journal = {Burns},
title = {Effect of timing of tracheostomy on changes in bacterial colonisation of the lower respiratory tract in burned children},
volume = {39},
year = {2013}
}
TY - JOUR
ID - 1163544
AU - Lipový, Břetislav - Brychta, Pavel - Řihová, Hana - Suchanek, I. - Hanslianova, M. - Cvanová, Michaela - Chaloupková, Zuzana - Gregorová, Nora - Hufová, Iva
PY - 2013
TI - Effect of timing of tracheostomy on changes in bacterial colonisation of the lower respiratory tract in burned children
JF - Burns
VL - 39
IS - 2
SP - 255-261
EP - 255-261
PB - ELSEVIER SCI LTD
SN - 03054179
KW - Burns
KW - Tracheostomy
KW - Bacteria
N2 - 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.
ER -
LIPOVÝ, Břetislav, Pavel BRYCHTA, Hana ŘIHOVÁ, I. SUCHANEK, M. HANSLIANOVA, Michaela CVANOVÁ, Zuzana CHALOUPKOVÁ, Nora GREGOROVÁ a Iva HUFOVÁ. Effect of timing of tracheostomy on changes in bacterial colonisation of the lower respiratory tract in burned children. \textit{Burns}. OXFORD: ELSEVIER SCI LTD, 2013, roč.~39, č.~2, s.~255-261. ISSN~0305-4179. Dostupné z: https://dx.doi.org/10.1016/j.burns.2012.05.023.
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