灵活和刚性支气管镜检查在体外膜氧化重症儿童的灵活和刚性支气管镜检查
Ashley Young1, Krupa Patel1,2, Kiona Allen1,3
1Feinberg School of Medicine, Northwestern University, Chicago, Illinois, U.S.A.
The Laryngoscope
|April 23, 2024
概括
在体外膜氧化 (ECMO) 的儿童中进行支气管检查可能有助于脱管,但会带来风险. 副作用与程序号和气道阻塞有关,而不是ECMO类型.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 干预性肺病学 干预性肺病学
背景情况:
- 身体外膜氧化 (ECMO) 是对重症儿童的生命支持措施.
- 气管支气管阻塞可能会使ECMO支持复杂化,并阻碍脱.
- 支气管镜检查是诊断和管理呼吸道问题的潜在工具.
研究的目的:
- 评估需要ECMO的儿童的支气管镜检查的经验和结果.
- 评估支气管镜检查在脱管前缓解气管支气管阻塞的安全性和有效性.
- 在ECMO患者的支气管镜检查期间识别与不良事件相关的因素.
主要方法:
- 从2018年1月到2022年12月对儿童进行ECMO的回顾性队列研究.
- 在ECMO支持期间对37名患者进行的99次支气管镜检查的分析.
- 经过支气管镜检查的患者与未经过支气管镜检查的患者之间的结局和不良事件的比较.
主要成果:
- 35%的ECMO患者接受了99个支气管镜检查.
- 在支气管镜检查后的13/25名患者中观察到潮体积的临床改善 (p=0.05).
- 49%的患者出现了不良事件 (肺胸炎,肺炎,出血,败血症);与手术数和阻塞有关.
- 在经过支气管镜检查的患者中,ECMO持续时间更长,并发症率更高.
- 死亡率在各组之间是相似的.
结论:
- 需要ECMO支气管镜检查的儿童病情危急.
- 支气管检查可以使患有持续心肺衰竭的儿童受益,有助于脱.
- 支气管镜检查次数和阻塞物质的存在是不良事件的关键因素.
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