在接受心脏手术的婴儿中,术后结节异位性心动减速症的流行病学
Michael E Kim1, Shankar Baskar2, Christopher M Janson3
1Department of Critical Care Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
The Annals of thoracic surgery
|March 14, 2024
概括
结节性宫外动脉 (JET) 在先天性心脏手术后影响了6%的婴儿,增加了资源使用,但并没有增加死亡率. 在JET治疗中显著的中心变异性凸显了对可修改因素的进一步研究的需要.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 心脏外科手术 心脏外科手术
- 关键护理医学 关键护理医学
背景情况:
- 结节性宫外动心 (JET) 是先天性心脏手术后的一种已知的并发症,发生在2%至8.3%的病例中.
- 之前的单中心研究表明,JET与术后发病率有关.
- 这项研究提供了多中心流行病学描述治疗的JET使用小儿心脏急症监护联盟注册.
研究的目的:
- 描述受治疗的结节性宫外动脉动 (JET) 在接受先天性心脏手术的婴儿的流行病学.
- 为了确定与外科手术后JET发展相关的风险因素.
- 评估JET对术后结果的影响.
主要方法:
- 在2019年2月至2022年8月期间接受JET治疗的患者的回顾性分析.
- 纳入标准:在手术时12个月以下的婴儿,并在术后72小时内接受JET治疗.
- 使用多级物流回归和利率/可归因风险分析来确定风险因素和结果影响.
主要成果:
- 在来自63个中心的24,073名患者中,6.0% (1436) 接受了JET治疗,中心变异性显著 (0%-17.9%).
- 独立的JET风险因素包括新生儿年龄,亚洲种族,更长的心肺旁路时间,开放的胸骨和早期使用异位药物.
- JET与增加机械通风 (IRR 1.6) 和ICU停留时间 (IRR 1.3),但与死亡率无关.
结论:
- 结节性宫外性心力衰竭 (JET) 在6%的儿科心脏手术患者中得到治疗,显示出相当大的中心变异性.
- JET有助于增加术后资源利用率,特别是机械通风和ICU停留.
- 进一步调查高中心变化的原因是有必要的,以确定可改性因素,以改善患者的治疗结果.
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