Name Andrew V. Morenkov, Olga M. Perminova, Elena V. Morenkova
Address Institute of Clinical Immunology, 14 Yadrintsevskaya Str., Novosibirsk, 630091 , Russia
Aim: Stenotic laringotracheites with children under 3 are a common pathology that, given pulmonary insufficiency, requires intensive care. When drug therapy proves inefficient, trachea intubation is used for the term of 2 or 3 days to restore respiration and to ensure conservative treatment, which is less harmful than tracheotomy. However, certain patients have to undergo lasting intubation, which, given the specifics of the pathological process characteristic of those patients, may lead to pulmonary insufficiency during the extubation procedure. Due to insufficient efficacy of modern methods used to discontinue long-term intubation, we have developed, on the basis of Chinese original sources, acupupressure techniques to be employed during extubafion.
Method: Patients were administered treatment according to modern standards used in intensive care units. In the period between 1994 - 1997 there have been 7 cases of prolonged intubation that lasted 10 - 26 days involving 6 children, age 3 months - 18 months. Diagnosis and treatment were based on the system of "childrens" acupuncture points, the follow-up assessment included monitoring kinesthetic changes in the acupoints Tiantu, Xinjiang, Feijin, Shenshui. Acupressure procedures started 3 - 5 minutes before extubation and to continue for 1,5 - 4 hours after the tube removal, depending on the absence of the tendency for the pulmonary insufficiency to increase. In 3 cases extubation was successful in the first attempt, 4 cases required a repeated procedure after 2 - 3 days.
Results: The general efficacy of acupressure employed during extubation in the cases described was 100%. 4 children did not show any recidivation during the follow-up; in one case a 3-month-old patient suffered a regression after 6 month, which required a repeated intubation accompanied by acupressure techniques; 1 child suffers from recidivations 2 - 3 times a year, which are resolved without intubation use.
Conclusion: The developed acupressure techniques for children exposed to prolonged intubation due to acute laringotracheitis allows the respiration function to be restored and stabilized without surgical correction in complicated cases. Treating specific "childrens" acupoints increases the effectiveness of the treatment process.