阻塞性睡眠呼吸暂停和儿童心脏手术后的短期结果
Adil Y Khan1, Brian Curry1, Andrew Jergel1
1Emory University School of Medicine, Atlanta, GA, USA.
Pediatric cardiology
|July 15, 2024
概括
患有阻塞性睡眠呼吸暂停 (OSA) 的儿童在心脏手术后面临不良结果的风险增加. 早期的桃切除和腺切除可以减轻这些风险,这表明主动的OSA治疗对于儿科心脏手术患者至关重要.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 睡眠医学 睡眠医学
- 心血管外科心血管外科
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 与成年人的不良心血管结果有关.
- 儿童心血管外科手术对OSA影响的理解较少.
研究的目的:
- 调查阻塞性睡眠呼吸暂停 (OSA) 与接受心脏手术的儿童不良结果之间的关联.
- 评估先前的桃体切除术和腺切除术对这些结果的影响.
主要方法:
- 在心脏重症监护病房 (CICU) 的320名儿科患者 (1-18岁) 的回顾性匹配队列研究中.
- 倾向性得分匹配 (3:1) 用于比较患有和没有OSA的患者.
- 主要结局是长时间住院/重症监护室,机械呼吸,ECMO或死亡的组合.
主要成果:
- 患有OSA的患者出现不良结局的比率明显高 (42.5%对28.3%,p=0.027).
- OSA仍然与不良结果独立相关 (调整后OR为4.09,p<0.001).
- 之前的桃切除术和腺切除术消除了与OSA相关的风险增加.
结论:
- 患有OSA的儿科患者在心脏手术后出现不良结果的风险要大得多.
- 及时的呼吸道外科干预 (桃体切除和腺切除) 可能会消除OSA的负面影响.
- 在需要心脏手术的儿童中,应考虑主动管理OSA.
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