儿童心脏性休克的临床表现,分类和结果
Kriti Puri1, Jacob C Jentzer2, Joseph A Spinner3
1Lillie Frank Abercrombie Division of Pediatric Cardiology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA; Division of Pediatric Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
Journal of the American College of Cardiology
|January 31, 2024
概括
心脏性休克 (CS) 影响了26%的儿科急性不补偿性心力衰竭住院治疗,增加了死亡风险. 一个新的CS严重程度尺度有效地预测了儿童住院死亡率.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 关键护理医学 关键护理医学
- 心脏衰竭研究研究
背景情况:
- 关于儿科心脏性休克 (CS) 流行病学和结果的数据有限.
- 成年人对CS的研究正在增长,但儿童仍未得到充分研究.
研究的目的:
- 描述儿科CS的流行病学,临床表现和结果.
- 确定急性不补偿性心力衰竭 (ADHF) 的儿童中CS和住院死亡率的风险因素.
- 开发和验证儿童患者的CS严重程度分类.
主要方法:
- 对21岁以下患者的ADHF住院病例的回顾性队列研究.
- 对表现时CS患者的分析,包括风险因素和结果.
- 改进心血管血管血管学与干预协会 (SCAI) 的冲击分类和分期的开发.
主要成果:
- CS发生在26%的儿科ADHF住院患者中 (n=207/803).
- 脑脊髓病与较差的缩功能,较高的BNP和增加的/肝损伤有关.
- 患有CS的儿童在医院死亡率较高 (28%对11%),需要更多的机械通风和循环支持.
- 每次CS阶段的增加都与更高的住院患者死亡率相关.
结论:
- CS是儿科ADHF的一个显著并发症,发生在26%的病例中.
- CS是儿童医院死亡率的独立预测指标.
- 修改后的SCAI分类有效地预测了儿科CS的死亡风险增加.
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