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侵入性机械通风和医院获得的静脉血栓栓塞的风险
Elizabeth E Havlicek1, Jamie Palumbo2, Gerardo Soto-Campos2
1Department of Pediatrics, University of South Florida Morsani College of Medicine, Tampa, Florida.
侵袭性通风的重症儿童患有医院获得的静脉血栓栓塞 (VTE) 的风险明显更高. 侵入性通风暴露和持续时间是该人群中VTE的独立风险因素.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 儿科血栓形成症 儿童血栓形成症
- 医疗保健相关的感染
背景情况:
- 医院获得的静脉血栓塞栓症 (VTE) 是重症儿童的严重并发症.
- 侵入性通风作为该人群中VTE风险因素的作用需要进一步阐明.
研究的目的:
- 估计医院获得的VTE的累积发病率和几率在患有和没有侵入性通风的重症儿童中.
- 描述侵入性通风和医院获得的VTE发展之间的时间关系.
主要方法:
- 使用来自142个北美儿科ICU (2016-2022) 的虚拟儿科系统 (VPS) 数据进行回顾性队列研究.
- 包括18岁以下的儿童,其队列通过侵入性通风暴露来确定.
- 多变量逻辑回归以评估侵入性通风作为VTE (深静脉血栓或肺栓塞) 的独立风险因素.
主要成果:
- 在691,118名儿童中,有12.4%的儿童接受了侵入性通风.
- 在医院获得的VTE发病率为1.9%的侵入性通风 vs. 0.12%没有 (P < .001).
- 侵袭性通风暴露 (aOR 1.64) 和持续时间 (aOR 1.03) 独立地与VTE发展有关.
结论:
- 侵入性通风是重症儿童在医院获得VTE的独立风险因素.
- 侵入性通风的持续时间进一步增加了VTE风险.
- 接受侵入性通风的儿童是VTE风险分层和预防试验的关键目标群体.
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