评估严重喉膜炎后进行超管整形术的重症监护入院的需要
Carolanne Gagnon1, Simon Bérubé2, Michaël Sauthier3,4
1Department of Pediatric Otolaryngology-Head and Neck Surgery, CHU Ste-Justine, Montreal, Quebec, Canada.
The Laryngoscope
|June 19, 2023
概括
过早生育,神经疾病和年轻年龄增加了因喉瘤而经过膜整形术后ICU入院的风险. 大多数需要进入重症监护室 (ICU) 的患者在手术后4小时内就能被确定.
科学领域:
- 儿科耳鼻喉科 儿科耳鼻喉科
- 儿科麻醉学 儿科麻醉学
- 儿科重症监护 儿科重症监护
背景情况:
- 术后的呼吸道问题仍然是为儿童进行喉顶手术的挑战.
- 虽然并发症率很低,但了解导致重症监护室 (ICU) 入院的因素对于患者管理至关重要.
研究的目的:
- 在儿科患者中确定后的supraglottoplastyICU入院的预测因素.
- 为临床决策提供有关术后监测和护理途径的信息.
主要方法:
- 在2014年至2021年间,对134名小儿科患者进行了后期的队列分析,这些患者接受了膜整形.
- 密切护理的关怀水平是由呼吸支持 (输管,通风,高流量鼻腔管或上腺素) 的需要来定义的.
主要成果:
- 27%的患者需要接受ICU治疗.
- 与ICU入院相关的因素包括早产 (OR 13.8),神经疾病 (OR ∞),美国麻醉学会3-4类 (OR 6.5) 和年轻年龄 (OR 1.8).
- 没有超过10个月的患者需要ICU监测,97%的ICU入院患者在手术后4小时内被发现.
结论:
- 大部分儿童需要在超位整形术后接受ICU护理,并确定了关键的危险因素.
- 需要ICU护理的患者的早期识别在术后4小时内是可能的.
- 在最初的麻醉后护理单位观察期后,可以在ICU外安全监测选定的患者.
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