A Clinical Study On Stress Response To Critical Ill Children With Tracheal Intubation In PICU

Objective: Critical ill children may need tracheal intubation due to various causes of respiratory failure.Tracheal intubation and mechanical ventilation is a routine treatment for respiratory failure.At the same time,it aggravates the stress response of children in PICU.By comparing the stress indicators before and after tracheal intubation and after sedation,we explore the effect of tracheal intubation on critical children about stress response,observe the effect of sedative drugs oncritical children with stress response,and analyze the relationship between stress response and prognosis.Methods: To collect the critical childeran from the Shengjing Hospital affiliated to China Medical University from January 1,2017 to December 31,2017.According to the inclusion and exclusion criteria,a total of 35 children were included in the study.Comparison of tracheal intubation before and after sedation,respiratory(R),mean arterial pressure(MAP),heart rate,blood pressure(BP),blood glucose,adrenocorticotropic hormone(ACTH),cortisol(Cor)has differencesbetween them;according to the different prognosis,divide into survival group and non survival group,analysis of the relationship between stress intensity and prognosis,according to the children with primary disease,divide into pulmonary group and non pulmonary group,comparison of stress index changes between the mutation rate and different diseases.Results: 1.The measured values of after tracheal intubation,BP,MAP,P,ACTH and cortisol are higher than before intubation.The difference is statistically significant(P<0.05).2.After sedation,the measured values of BP,MAP,P,R,ACTH and cortisol are all decreased,and the difference is statistically significant(P<0.05).3.The variation rate of ACTH and tcortisol in the survival group are higher than those in the non survival group,and the difference is statistically significant(P<0.05).4.The patients in the pulmonary origin group have longer time of hospitalization,less age and better prognosis than those in the non pulmonary group,and the difference is statistically significant(P<0.05).Conclusion: Endotracheal intubation aggravate the stress reaction of critically ill children.The use of sedative drugs slow down the stress response of children,and children with poor stress response ability indicate poor prognosis.