儿童移植:在夜间或白天进行是安全的吗?
Filippo Ghidini1,2, Marina Andreetta3, Federica De Corti4
1Department of Women's and Children's Health, University of Padua, Padua, Italy. filippo.ghidini@studenti.unipd.it.
Pediatric surgery international
|March 20, 2024
概括
在休息时间后进行的儿科脏移植显示出类似的结果,但休息日手术的持续时间更长,出血更多. 需要小心对日间儿科移植进行仔细的注意,以防止并发症.
科学领域:
- 儿科脏病学 儿科脏病学
- 移植手术 移植手术
- 医疗保健管理的管理
背景情况:
- 在儿科移植 (KT) 中,开业后的手术越来越常见.
- 了解手术时间对移植结果的影响对于患者护理至关重要.
- 之前对小儿科开放时间CT结果的研究是有限的.
研究的目的:
- 调查外科手术对儿科脏移植结果的影响.
- 为了比较普通的日间,日间休息和夜间儿科KTs之间的移植功能,并发症和手术参数.
主要方法:
- 在2013-2021年期间在一个机构进行的儿科KT的回顾性审查.
- 根据切口时间将手术分类为普通白天,休息日和夜间.
- 缺血时间,手术长度,并发症,延迟移植功能 (DGF),初级移植非功能 (PGNF) 和3个月的eGFR的比较.
主要成果:
- 分析了96种儿科科疗法,43%发生在夜间,29%发生在白天休息期间.
- 所有组的缺血时间都相似.
- 日间KTs的手术持续时间明显长,手术后出血的发生率更高,尽管整体并发症率,DGF,PNGF和3个月的eGFR相似.
结论:
- 显著比例的儿科科疗法是在下班时间进行的,包括白天休息和夜间休息.
- 虽然整体移植结果无论时间如何都是相似的,但由于手术时间延长和出血风险,日间手术需要提高警.
- 为了减轻潜在的并发症,进一步研究和优化日间儿科KT的协议是有必要的.
相关概念视频
01:15Chronopharmacokinetics: Circadian Rhythms and Influence on Drug Response
Circadian rhythms are cyclic changes that are crucial in plasma drug concentrations. Various standard circadian parameters, including core body temperature, heart rate, and other cardiovascular factors, directly impact disease states and the therapeutic response to drug therapy.
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...
The time of drug administration is an important factor to consider, as it can influence the toxic dose of a drug. For example, a study conducted by Prins et al. in 1997 examined the effects of the timing of...
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
01:28Kidney Transplant I: Introduction
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
01:26Kidney Transplant II: Surgical Procedure
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...
01:16Kidney Transplant III: Nursing Management
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...