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在接受单肺通风的学龄儿童中出现低氧症:来自多中心外科术期结局组的回顾性队列研究
T Wesley Templeton1, Bridget Krol2, Scott Miller1
1Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
Anesthesiology
|September 22, 2023
概括
在接受单肺通风的儿童中,低氧症的风险与初始氧和低于98%有关. 诸如体重过重和右侧手术等因素会增加老年儿童的风险.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 胸部外科手术 胸部外科手术
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 在儿童的单肺通风 (OLV) 期间的低氧症并未得到充分了解.
- 识别风险因素对于改善患者的治疗结果至关重要.
- 这项研究调查了与儿科OLV低氧化症相关的可修改和不可修改的因素.
研究的目的:
- 在接受OLV胸部手术的学龄儿童 (4-17岁) 中识别低氧血症的危险因素.
- 为了区分年轻的 (4-9岁) 和年长的 (10-17岁) 儿科队伍之间的风险因素.
主要方法:
- 对多中心期经操作结果组数据库的回顾性分析.
- 包括接受OLV的4-17岁儿童,不包括心脏/血管手术.
- 低氧化症 (SpO2<90%≥3分钟) 和严重的低氧化症 (SpO2<90%≥5分钟) 的定义.
- 多变量回归分析以评估风险因素,包括年龄,体重,ASA状态,OLV持续时间,初始SPO2,手术方法和通风策略.
主要成果:
- 低氧症的患病率在4至9岁儿童中为10.5%,在10至17岁儿童中为7.5%.
- 在各自年龄组中,严重低氧化血症的患病率为6.1%和4.6%.
- 初始SPO2<98%是两个年龄组中缺氧症的重要危险因素.
- 体重极端,右侧手术和年龄较小 (在老年队列中) 与低氧症风险增加有关.
结论:
- 室内空气初始氧和率低于98%是接受OLV的儿童缺氧的关键危险因素.
- 体重极端,右侧手术和年轻年龄 (在老年人群中) 是低氧血症的重要危险因素.
- 这些发现有助于儿童胸部手术患者的风险分层和管理策略.
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