心声扫描后的管理变化与重症儿童的改善结果有关
Pui Yin Florence Ip1,2, Uvaraj Periasamy2,3,4, Steven J Staffa2,3
1Department of Medicine, Boston Children's Hospital, Boston, MA.
概括
心声学指导重症儿童的管理变化. 对于那些心脏功能低下的人来说,从血管收缩剂切换到异型药物可以缩短重症监护的持续时间.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 心脏病学 心脏病学
- 儿科重症监护中的心声学.
背景情况:
- 正式心声回声仪对于评估重症儿童的心脏功能至关重要.
- 儿科重症监护室 (ICU) 的管理决策通常需要精确的心脏状况评估.
研究的目的:
- 评估以心声学为指导的管理变化对重症儿童治疗结果的影响.
- 评估心脏功能状态与随后的治疗策略和患者结果之间的关联.
主要方法:
- 在2011年至2020年期间,重症儿童 (1-18岁) 进入第三级儿童医院的回顾性队列研究.
- 患者被分为近乎正常或抑郁的心脏功能组,基于ICU入院后72小时内进行的心声回声学,直管和血管活性输液.
- 对临床数据和管理策略 (血管活性和流体) 进行了分析,与心声回声计时和患者结果相关.
主要成果:
- 在心脏功能丧的儿童中,血管收缩剂的使用与乳酸清除和氧气提取较差,肺水增加和氧化水平较差 (SpO2 / FiO2) 相关联.
- 心声扫描揭示了心脏功能衰退,往往导致人们转向异型药物和保守的流体管理.
- 与继续服用静脉缩剂的患者相比,转换为内类药物的心脏功能抑郁的患者经历了较短的机械呼吸和血管活性支持时间.
结论:
- 在心脏功能丧的重症儿童中,心声导向的管理调整与减少的重症监护干预有关.
- 及时评估和修改基于心声回声学发现的治疗策略可以优化儿童重症监护室患者的康复.
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