小児麻酔における呼吸道合併症のリスク評価:前向きなコホート研究
Britta S von Ungern-Sternberg1, Krisztina Boda, Neil A Chambers
1Department of Anaesthesia, Princess Margaret Hospital for Children, Perth, WA, Australia. bvonungern@uhbs.ch
Lancet (London, England)
|September 7, 2010
まとめ
呼吸器疾患または家族性喘息の歴がある子供は,外科手術後の呼吸器系有害事象のリスクが高くなります. ターゲットを絞った麻酔管理は,これらのリスクを軽減し,小児麻酔の安全性を改善することができます.
科学分野:
- 小児麻酔医の麻酔学について
- 呼吸器医学とは
- クリニカルリスクマネジメント
背景:
- 術後の呼吸器の有害事象は,小児麻酔における罹病率と死亡率の重要な原因である.
- リスク要因を特定することは,患者のアウトカムを改善するために非常に重要です.
研究 の 目的:
- 家族の病歴,麻酔管理,および小児における手術前呼吸器の有害事象の発生との関連を調査する.
- これらのイベントのリスクの高い子どもを特定する.
主な方法:
- 全身麻酔を受けた9297人の子どもを対象とした前向きな研究.
- 幼児における喘息とアレルギーの国際研究グループのアンケートに適応したデータです.
- 家族の病歴,呼吸器系の症状,麻酔管理の詳細が含まれていました.
主要な成果:
- 陽性な呼吸経歴 (例えば,咳,喘息,湿疹) は,気管支炎,喉支炎,呼吸道阻害のリスクを大幅に増加させる.
- 最近の上部呼吸道感染 (URTI) はリスクが増加し,2~4週間前のURTIはリスクが低下した.
- 喘息/アトピー/喫煙の家族歴および特定の麻酔技術 (例えば,吸入誘導,フェイスマスクの使用) は,リスクの増加と関連していました.
結論:
- 術後の呼吸器の有害事象のリスクが高い子供は,麻酔前評価で特定することができます.
- 調整された麻酔管理戦略は,これらのリスクの高い子供たちの安全性を向上させることができます.
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