儿童麻醉中呼吸道并发症的风险评估:一个前性队列研究
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
概括
患有呼吸系统问题或家族喘病史的儿童面临更高的外科手术期间呼吸系统不良事件的风险. 有针对性的麻醉管理可以减轻这些风险,提高儿科麻醉的安全性.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 呼吸系统医学 呼吸系统医学
- 临床风险管理临床风险管理
背景情况:
- 术后呼吸系统不良事件是儿科麻醉中发病率和死亡率的重要原因.
- 识别风险因素对于改善患者的治疗结果至关重要.
研究的目的:
- 调查家庭病史,麻醉管理和儿童外科手术期间呼吸系统不良事件的发生之间的联系.
- 为了确定这些事件的高风险儿童.
主要方法:
- 对9297名接受全身麻醉的儿童进行前性研究.
- 通过适应的儿童喘和过敏国际研究小组调查问卷收集的数据.
- 包括家庭病史,呼吸系统症状和麻醉管理细节.
主要成果:
- 积极的呼吸史 (例如,咳,喘息,湿疹) 显著增加了支气管,喉,呼吸道阻塞的风险.
- 最近的上呼吸道感染 (URTI) 增加了风险,而 2-4 周前的 URTI 降低了风险.
- 患有喘/喘/吸烟的家族史和特定的麻醉技术 (例如,吸入诱导,面罩使用) 与风险增加有关.
结论:
- 在术前呼吸系统不良事件的高风险的儿童可以在麻醉前评估中确定.
- 量身定制的麻醉管理策略可以提高这些高危儿童的安全性.
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