Exploration on the Application of Airway Care Measures During the Coma Period in Pediatric Patients with Severe Craniocerebral Injury

Abstract

Objective: This study aims to systematically evaluate the practical effects of an integrated airway care protocol in the clinical management of pediatric patients with severe craniocerebral injury in a coma, with the core objective of reducing airway-related complications and optimizing treatment outcomes. Methods: A prospective study was conducted involving 76 pediatric patients with severe craniocerebral injury in a coma who were admitted to the PICU of our hospital from January 2022 to December 2023 and met the inclusion criteria. These patients were randomly divided into an intervention group and a conventional group, with 38 cases in each group. The conventional group received standard neurosurgical airway care, while the intervention group implemented a systematic care strategy encompassing precise humidification, programmed suctioning, individualized positioning adjustments, and early respiratory function intervention. The incidence of ventilator-associated pneumonia and airway mucosal injury, duration of invasive ventilation, length of stay in the PICU, and improvements in arterial oxygen and carbon dioxide partial pressures before and after intervention were recorded and compared between the two groups. Results: The incidence of ventilator-associated pneumonia in the intervention group was 13.16%, significantly lower than the 34.21% in the conventional group. The incidence of airway mucosal injury in the intervention group was 10.53%, also lower than the 28.95% in the conventional group. In terms of time indicators, the intervention group had shorter average durations of mechanical ventilation and PICU stay compared to the conventional group. Blood gas analysis results showed that the intervention group had greater increases in arterial oxygen partial pressure and decreases in carbon dioxide partial pressure than the conventional group, with statistically significant differences between the groups. Conclusion: Comprehensive and proactive airway care interventions during the coma period in pediatric patients with severe craniocerebral injury can effectively safeguard airway function integrity, significantly reduce the risk of major complications, accelerate the critical care process, and thereby provide more stable support conditions for neurological recovery. This protocol holds clinical practical value.