Long term ventilated children in ICU,what is best,nasal intubation, oral intubation or tracheostomy?

https://intensivecarehotline.com/blog/quick-tip-for-families-in-icu-long-term-ventilated-children-in-icu-what-is-best-nasal-intubation-oral-intubation-or-tracheostomy/

Quick tip for families in Intensive care: Long term ventilated children in ICU, what is best, nasal intubation, oral intubation or tracheostomy?

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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

Today’s quick tip and question’s answered is about a 6-year old girl that’s in the ICU after a bacterial encephalitis. She is on a ventilator currently and breathing tube is in her mouth. She has cerebral edema. She has a herniation as part of the encephalitis as part of a brain herniation.

She has been in ICU for about a month. Now she’s on TPN . She’s getting 3% sodium to manage brain pressure. She’s also on steroids and she’s on immunoglobulins. And the families are saying that their little girl hasn’t been able to wake up, she is not doing any purposeful movements. The ICU is suggesting that a tracheostomy might be the next step.

Now let’s look at the pediatric world and tracheostomies. Generally speaking, a lot of pediatric patients in ICU are intubated through the nose instead of the mouth. And intubation through the nose, generally speaking, can be so much better tolerated compared to, intubation through the mouth.

So maybe the next step is to intubate their 6-year old girl through the nose and see whether she can wake up. And then if she can’t come off the ventilator, maybe then do a tracheostomy .

Continuation...
https://intensivecarehotline.com/blog/quick-tip-for-families-in-icu-long-term-ventilated-children-in-icu-what-is-best-nasal-intubation-oral-intubation-or-tracheostomy/