经过复杂心脏手术的新生儿的腹膜导管:一项多中心描述性研究
David M Kwiatkowski1, Jeffrey A Alten2, Tia T Raymond3
1Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA.
Cardiology in the young
|June 20, 2023
概括
在新生儿心脏手术后,腹膜导管的使用在各中心之间有很大差异. 这项研究在接受腹腔导管用于透析或排水的新生儿中,在不良事件,液体过载或急性损伤方面没有发现差异.
科学领域:
- 新生儿手术 新生儿手术
- 儿科病学 儿科病学
- 心脏病学 心脏病学
背景情况:
- 腹腔导管用于透析或排水新生儿心脏手术后,以管理流体过载.
- 然而,多中心的可变性和特定的使用细节尚未得到充分记录.
研究的目的:
- 描述在接受复杂心脏手术的新生儿中使用多中心腹膜导管.
- 分析与导管使用相关的患者特征和结果 (急性损伤,液体平衡).
主要方法:
- 一项22个中心的研究 (NEPHRON) 分析了1490名新生儿的数据,这些新生儿接受了STAT类别3-5的心脏手术,并进行了心肺绕道.
- 患者被分为三组:透析的腹管,被动排水的腹管和没有导管.
- 结果被评估为六个术后的日子.
主要成果:
- 32%的新生儿接受了手术内腹导管 (12%的透析,20%的排水).
- 导管的使用在各中心有很大差异,有些中心在50%以上的新生儿中使用导管.
- 血清肌素,液体平衡,不良事件或群体之间的死亡率没有显著差异.
结论:
- 腹膜导管的使用是常见的,但在接受复杂心脏手术的新生儿中非常可变.
- 导管使用与更高的外科复杂性有关,但不增加不良事件或死亡率.
- 液体过载和急性损伤率是相似的,无论腹腔管导管的使用.
相关概念视频
Parentral Nutrition: Centeral and Peripheral Parental Nutrition
229
Parenteral Nutrition (PN) delivers essential nutrients directly into the bloodstream, bypassing the digestive system. It is commonly used for individuals with severe digestive disorders or conditions that prevent normal nutrient absorption.
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
229
Cardiomyopathy VII: Pre and Post Operative Nursing Management
16
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
16
Cardiac Catheterization I: Pre-Procedure Overview
77
Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
77
Cardiac Catheterization III: Left Heart Catheterization
87
Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
87
Cardiac Catheterization IV: Nursing Management
76
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
76
Endoscopic Studies II: Thoracocentesis
361
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
361


