在儿科患者全身麻醉期间的氧化:一项回顾性观察性研究
Jan J van Wijk1, Albina Musaj1, Sanne E Hoeks1
1Department of Anesthesiology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Journal of clinical anesthesia
|February 7, 2024
概括
儿科麻醉缺乏使用氧气的协议,导致频繁的高氧化. 这项研究发现,儿童的氧气度与血液氧气水平之间存在中度联系,90%的儿童有过多的氧气.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 关键护理医学 关键护理医学
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 限制使用氧气的协议是重症监护和急救机构的标准.
- 与其他医学领域不同,儿科麻醉学目前缺乏既定的氧气管理协议.
- 这一差距凸显了需要了解当前在儿科全身麻醉中使用氧气的做法.
研究的目的:
- 为了调查在儿科全身麻醉期间的氧气管理实践.
- 为了将氧气度 (FiO2) 与动脉血液气体测量相关联,特别是氧气部分压力 (PaO2),氧和度 (SpO2) 和动脉氧和度 (SaO2).
主要方法:
- 一项回顾性观察性研究在一家高等儿科学术医院进行.
- 分析了226名儿科患者 (0-18岁) 的数据,这些患者接受了气管管道输液和动脉导管治疗的全身麻醉.
- 从电子健康记录中审查了氧化管理和动脉血液气体分析.
主要成果:
- 对645个样本的分析显示,吸入氧气 (FiO2) 的中位数为36%,中位数PaO2为23.6kPa (177mmHg).
- 中位数的SpO2为99%. 在PaO2和FiO2 (r=0.52,p<0.001) 之间发现了中度积极的关联.
- 大约90%的分析样本 (574/645) 表示高氧化,PaO2超过13.3 kPa (100 mmHg).
结论:
- 在小儿整体麻醉期间的氧气管理在很大程度上不受管制.
- 术内高氧化症很普遍,约90%的儿科病例发生.
- 建议进行进一步的研究,以探索与儿科手术内高氧化症相关的临床结果.
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