与难以进入动脉和在手术室使用超声波相关的患者和技术因素
Frank M Yanko1,2, Adovich Rivera1,2, Eric C Cheon1,2
1Feinberg School of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
Children (Basel, Switzerland)
|January 23, 2024
概括
多次动脉导管试验与非心脏手术和非辐射动脉放置有关. 超声波的使用在年轻患者和心脏手术中更常见,有助于第一次尝试取得成功.
科学领域:
- 麻醉学 麻醉学
- 儿科重症监护 儿科重症监护
背景情况:
- 动脉导管对于血液动力学监测至关重要,但存在风险,特别是在多次插入尝试时.
- 识别与插入困难相关的因素以及使用超声波等先进技术对于提高患者安全至关重要.
研究的目的:
- 调查与多次动脉导管试验相关的临床因素.
- 探索影响儿童患者在动脉导管治疗期间超声波使用的因素.
主要方法:
- 在第三级儿童医院进行了3946次动脉导管插入的回顾性分析 (2018年1月 - 2022年3月).
- 多变量分析以确定多次尝试和超声波利用的预测因素.
- 探索性分析与第一次尝试成功相关的因素.
主要成果:
- 多次尝试与非心脏手术 (儿科,神经学,骨科) 和非辐射动脉安置 (p < 0.001) 有关.
- 在年轻患者 (新生儿到儿童) 和心脏手术 (p < 0.001) 中,超声波的使用率更高.
- 首次尝试的成功与心脏手术,触摸和辐射动脉安置有关;超声波的使用与年轻的年龄,更高的ASA状态,心脏手术和麻醉师安置有关.
结论:
- 非心脏手术和非辐射动脉方法增加了多次动脉导管试验的可能性.
- 超声波首选用于年轻的儿科患者和心脏手术,可能会提高第一次尝试的成功率.
- 了解这些因素可以优化动脉导管策略,减少并发症,并改善患者的治疗结果.
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