The diagnosis, prevention, treatment and prognosis of subglottic sputum crusts in neonates

Abstract

Abstract Objective: To investigate the risk factors of subglottic sputum crust formation in neonates in the NICU through flexible bronchoscopy, as well as prevention，treatment measures and prognosis. Methods: A retrospective study was conducted on 152 neonates in NICU who underwent bronchoscopy during June 2018 to June 2023. The influencing factors of subglottic sputum crustformation were analyzed and The incidence and prognosis of subglottic sputum crustby after improved nursing methods were compared and analyzed. Results: ① In term of the history of invasive mechanicalventilation and the duration of invasive mechanical ventilation,the incidence of the subglottic sputum crust in the experiment group was higher than that of control group(P＜0.05）. ② After improved nursing methods, the incidence of subglottic sputum crust in the experiment group was lower than that of control group(P＜0.05）. ③ The group with early bronchoscopy after weaning has lower incidence of related complication than the group with late bronchoscopy(P＜0.05). Conclusion: Invasive mechanical ventilationand the duration of ventilation were the main risk factors for subglottic sputum crust formation. Strengthening humidification and sputum suction outside the tube during invasive mechanical ventilation will effectively prevent the formation of subglottic sputum crusts and reduce the occurrence of dyspnea after weaning. Early treatment after the formation of subglottic sputum crusts will optimize the removal of sputum crusts, avoid the formation of subglottic stenosis.