全球麻醉相关儿童心脏骤停率:系统性审查和元分析
Teofilo Augusto A Tiradentes1, Sharon Einav2, Jose R C Braz1
1Anaesthesia Cardiac Arrest and Mortality Study Commission, Department of Surgical Specialties and Anaesthesiology, Botucatu Medical School, Sao Paulo State University - UNESP, Botucatu, Sao Paulo, Brazil.
British journal of anaesthesia
|September 24, 2023
概括
与麻醉相关的儿童心脏骤停率在人类发展指数 (HDI) 较低的国家更高. 一岁以下的婴儿面临的风险最高,这表明在儿童麻醉安全方面存在持续的全球挑战.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 全球健康 全球健康
- 发育儿科 发育儿科
背景情况:
- 与成年人相比,新生儿和婴儿面临的术后风险增加.
- 以前的研究将麻醉的安全性与一个国家的人类发展指数 (HDI) 联系起来.
- 这项研究调查了儿童的麻醉相关心脏骤停率 (ARCAR),涉及国家HDI和时间.
研究的目的:
- 检查儿童与麻醉相关心脏骤停率 (ARCAR) 和国家人类发展指数 (HDI) 之间的关系.
- 分析随着时间的推移和不同HDI水平的ARCAR趋势.
- 为了确定特定的儿童年龄组在麻醉相关心脏骤停的风险较高.
主要方法:
- 在2022年7月之前对电子数据库进行系统审查和元分析.
- 分析每1万次麻醉手术的24小时术后ARCAR.
- 低HDI (HDI<0.8) 与高HDI (HDI≥0.8) 国家的ARCARs的比较以及跨时期的ARCARs (2001年之前与2001年至22年之前).
主要成果:
- 分析了38项研究,包括5,493,489次麻醉手术和1001次ARCAR.
- ARCAR显示与国家HDI的反相关性 (P<0.0001),但与时间没有相关性 (P=0.82).
- 在2001 - 22年,在HDI较低的国家 (9.6) 的ARCAR显著高于HDI较高的国家 (2.0).
- 在高HDI (OR 8.03) 和低HDI (OR 7.32) 国家的1岁以下儿童的ARCAR比1岁以上儿童高得多.
结论:
- 与麻醉相关的儿童心脏骤停率仍然是一个重大的全球性问题.
- 低HDI和高HDI国家之间的ARCAR差异凸显了儿童麻醉护理的全球不平等.
- 一岁以下的婴儿是特别易受伤害的人群,需要集中注意力来提高麻醉的安全性.
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