Analysis of PICU management and follow-up after Montgomery T-tube placement in children
10.3760/cma.j.issn.1673-4912.2024.05.005
- VernacularTitle:儿童Montgomery T管置入术后PICU管理及随访分析
- Author:
Yan DU
1
;
Letian TAN
;
Pan LIU
;
Lijia DU
;
Yuxin LIU
;
Jinhao TAO
;
Chao CHEN
;
Zhengzheng ZHANG
;
Guoping LU
;
Weiming CHEN
Author Information
1. 复旦大学附属儿科医院重症医学科，上海 201102
- Keywords:
Pediatrics;
Montgomery T-tube;
Airway management;
Mechanical ventilation
- From:
Chinese Pediatric Emergency Medicine
2024;31(5):342-348
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical situation of critically ill children with Montgomery T-tube，aiming to summarize the characteristics of T-tube application in pediatric and the experience of postoperative airway management in PICU.Methods:The etiology，clinical characteristics，complications and ICU admissions of patients with Montgomery T-tube admitted to the Pediatric Hospital of Fudan University from April 2019 to December 2021 were analyzed，and the application of T-tube in patients with critical conditions requiring long-term mechanical ventilation was described in the light of clinical experience.Results:During the study period,seven children were admitted to the PICU after T-tube insertion,including three males and four females,aged 9~75 months.Five children received mechanical ventilation.Among them,there were five cases with congenital laryngeal malformations,one case with tracheoesophageal fistula,and one case with laryngeal papilloma.The main complications were sputum blockage,infection,and granulation proliferation.One child died of secretion blockage,while the other children were successfully evacuated from the T-tube.The longest retention time of the T-tube was 367 days.Five patients experienced hoarseness after removing the T-tube,and upon re-examination with fiberoptic bronchoscopy,no recurrence of subglottic stenosis was observed.There was no respiratory distress or wheezing,and there were no abnormalities observed during regular outpatient follow-up after discharge.After discharge,the quality of life of the six surviving children improved compared to preoperative,and they all resumed oral feeding.There were no complaints of swallowing difficulties or aspiration during outpatient follow-up.But they were all combined with malnutrition.Conclusion:The Montgomery T-tube is a secure and dependable airway stent utilized for airway remodeling and the maintenance of airway patency following interventional surgery.For critically ill children,early management of airway clearance and infection prevention are imperative.
