在先天性心脏病手术后需要或不需要体外生命支持的心脏骤停
Nicole Bencie1, Fabio Savorgnan2, Ziyad Binsalamah3
1Warren Alpert Medical School of Brown University, Providence, Rhode Island; Arthur S. Keats Division of Pediatric Cardiovascular Anesthesia, Department of Anesthesiology, Perioperative and Pain Medicine, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.
The Annals of thoracic surgery
|September 13, 2023
概括
儿科心脏手术后的术后心脏骤停 (CA) 是一个严重的并发症. 一个新的预测模型,结合手术前风险因素和手术内数据,可以识别具有或没有体外心肺复苏 (ECPR) 的CA风险较高的患者.
科学领域:
- 儿科心脏手术 儿科心脏手术
- 心血管研究的心血管研究.
- 医学中的预测建模.
背景情况:
- 手术后心脏骤停 (CA) 和需要体外心肺复苏 (ECPR) 是儿科心脏手术后的重大并发症.
- 为这些事件开发可靠的预测模型对于改善患者的治疗结果至关重要.
研究的目的:
- 开发和验证儿童心脏手术患者的术后CA与或没有ECPR的预测模型.
- 为了确定术后CA的关键预测因素.
- 通过早期风险分层来改善患者的治疗结果.
主要方法:
- 对接受心肺旁路手术 (CPB) 的儿科患者进行了回顾性队列研究.
- 对人口统计数据,术前风险因素,STS-EACTS死亡率类别,术后数据,残留损伤得分 (RLS) 和血管活性-无热性得分 (VIS) 的分析.
- 用于开发预测模型的多变量逻辑回归.
主要成果:
- 有或没有ECPR的CA发病率为4.4%.
- 确定的预测因素包括:手术前风险因素的存在,较长的CPB持续时间,更高的手术内残留病变得分 (RLS) 和更高的术后血管活性-异位性得分 (VIS).
- 患有CA的患者年轻,需要更长的CPB和交叉时间.
结论:
- 在儿科心脏手术患者中开发了一种经过验证的术后CA与或没有ECPR的预测模型.
- 该模型与个人风险因素或得分相比表现优越,为风险分层提供了有前途的工具.
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