在小儿心脏手术后,关键疾病相关的皮质类固醇缺乏症 (CIRCI)
Aziez Ahmed1, Russell Kesman2, Madonna E Lee3
1Section of Critical Care Medicine, Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA.
World journal for pediatric & congenital heart surgery
|February 7, 2024
概括
术后危急疾病相关的皮质类固醇缺乏症可能会影响心肺旁路术后的一些新生儿. 本综述探讨了这种高风险群体的诊断和治疗,为类固醇治疗提供了机构指南.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 新生儿科学 新生儿科学
- 儿童心脏病学 儿童心脏病学
背景情况:
- 目前的证据不支持在儿科患者心肺旁路术后常规使用皮质类固醇.
- 严重疾病相关的皮质类固醇缺乏症 (CIRCI) 在儿科重症监护室 (ICU) 血动力学中的作用尚不清楚.
- 了解新生儿的CIRCI病理生理学对于有针对性的干预至关重要.
研究的目的:
- 审查关于CIRCI在重症新生儿中的现有文献.
- 确定一组可能从术后类固醇治疗中受益的儿科患者.
- 提出一种治疗算法,以实现CIRCI的最佳诊断和管理.
主要方法:
- 对皮质类固醇使用研究的文献综述和CIRCI在儿科和新生儿重症监护中的研究.
- 在重症新生儿中分析CIRCI的病理生理学.
- 基于机构经验的临床算法的开发.
主要成果:
- 确定类固醇治疗对经历CIRCI心肺旁路术后CIRCI心肺旁路术的特定新生儿的潜在益处.
- 强调需要进一步研究CIRCI的最佳诊断标准和治疗门.
- 拟议的算法提供了一种结构化的方法来管理这种高风险人群.
结论:
- 虽然不建议常规使用类固醇,但选择性使用可能会使新生儿受益于CIRCI心肺旁路术后的新生儿.
- 优化CIRCI的诊断和治疗对于改善这个脆弱群体的血液动力学稳定性至关重要.
- 机构算法作为管理高风险新生儿手术后CIRCI的指南.
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