Critical care medicine · 1991
Helium-oxygen mixture in the treatment of postextubation stridor in pediatric trauma patients.
Клиническое исследованиеСтатьяРандомизированное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Kemper K J, Ritz R H, Benson M S, Bishop M S
Аннотация
OBJECTIVE: To assess the effectiveness of a helium-oxygen mixture in reducing post-extubation stridor in children hospitalized for burns or trauma.
DESIGN: Randomized, controlled crossover trial.
SETTING: Harborview Medical Center's Burn and Trauma ICUs from March to September 1989.
PATIENTS: Children less than 15 yr old who were electively extubated and had symptoms of postextubation stridor, but required less than or equal to 35% oxygen.
INTERVENTION: Each treatment (helium-oxygen and oxygen-supplemented room air) was given in random order for 15 min after extubation.
MEASUREMENTS: Respiratory distress was assessed by a physician blinded to treatment order using a standard stridor score and clinical judgment.
RESULTS: There were 13 children with 15 extubations; seven (47%) of 15 patients required subsequent treatment with racemic epinephrine or reintubation. Stridor scores were lower with helium-oxygen than with oxygen-supplemented room air (2.8 vs. 3.7, p less than .005), and helium-oxygen was preferred in eight of nine trials in which one treatment was clearly favored by the physician.
CONCLUSION: Because helium-oxygen therapy can reduce stridor scores and is clinically preferred by physicians caring for stridorous children, it may be a useful adjunctive therapy in pediatric trauma patients with postextubation stridor.
DESIGN: Randomized, controlled crossover trial.
SETTING: Harborview Medical Center's Burn and Trauma ICUs from March to September 1989.
PATIENTS: Children less than 15 yr old who were electively extubated and had symptoms of postextubation stridor, but required less than or equal to 35% oxygen.
INTERVENTION: Each treatment (helium-oxygen and oxygen-supplemented room air) was given in random order for 15 min after extubation.
MEASUREMENTS: Respiratory distress was assessed by a physician blinded to treatment order using a standard stridor score and clinical judgment.
RESULTS: There were 13 children with 15 extubations; seven (47%) of 15 patients required subsequent treatment with racemic epinephrine or reintubation. Stridor scores were lower with helium-oxygen than with oxygen-supplemented room air (2.8 vs. 3.7, p less than .005), and helium-oxygen was preferred in eight of nine trials in which one treatment was clearly favored by the physician.
CONCLUSION: Because helium-oxygen therapy can reduce stridor scores and is clinically preferred by physicians caring for stridorous children, it may be a useful adjunctive therapy in pediatric trauma patients with postextubation stridor.