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在儿科重症监护室内输管的婴儿中,与输出管后流相关的因素
Deirdre Lewis1, Dev Darshan Khalsa2, Alexandra Cummings1
1Department of Pediatrics, Division of Critical Care Medicine, Cohen Children's Medical Center of New York, New Hyde Park, NY, USA.
Journal of intensive care medicine
|October 3, 2023
概括
长时间的机械通风和非选择性输入管增加了婴儿的输出管后风险. 更大的内管 (4.0) 也与更高的斯特里多率有关,指导临床决策.
科学领域:
- 儿科重症监护室的儿童重症监护室
- 关键护理医学 关键护理医学
- 新生儿科学 新生儿科学
背景情况:
- 输出管后 (PES) 是儿科重症监护室 (PICU) 的常见并发症.
- 婴儿特别容易感染PES,这可能导致输出管失败,长时间住院和增加死亡率.
- 确定婴儿PES的风险因素对于改善结果至关重要.
研究的目的:
- 为了调查婴儿 (1岁以下) 进入PICU后输出管后的相关因素.
- 确定通风持续时间,输管类型和内管大小对PES发育的影响.
主要方法:
- 从PICU对518名婴儿患者病历进行了回顾性审查.
- 主要结局:PES,定义为在输出后6小时内需要血性上腺素.
- 统计分析包括费舍尔的精确测试和多变量逻辑回归.
主要成果:
- 24.1%的婴儿患上了PES.
- 超过48小时的机械通风 (OR=1.75) 和非选择性输管 (OR=2.92) 显著增加了PES风险.
- 输内管尺寸4.0 (OR=1.96) 与尺寸3.5.5相比,与PES的相关性更高.
结论:
- 机械通风持续时间超过48小时和非选择性输内管是婴儿PES的主要危险因素.
- 与尺寸3.5相比,内管尺寸4.0与PES的风险增加有关.
- 这些发现有助于选择合适的内管,并识别高风险婴儿用于PES预防策略.
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