在接受心脏手术的新生儿中与腹腔导管使用相关的结果的评估:一个多中心研究
David M Kwiatkowski1, Jeffrey A Alten2, Kenneth E Mah1
1Department of Pediatrics, Stanford University School of Medicine, Palo Alto, Calif.
JTCVS open
|July 17, 2024
概括
在接受高风险心脏手术的新生儿中,手术内置腹膜导管放置并没有改善结果. 虽然急性损伤在导管使用时较低,但住院时间较长,这表明要仔细考虑使用.
科学领域:
- 儿科心脏手术 儿科心脏手术
- 新生儿重症监护中心
- 腎臟病學 (nephrology) 是一種醫學.
背景情况:
- 新生儿的高风险心脏手术往往需要心肺绕道.
- 腹腔导管用于透析或排水,但它们对结果的影响仍在争论中.
研究的目的:
- 为了确定手术内腹膜导管放置是否改善了接受高风险心脏手术的新生儿的结果.
- 评估腹腔导管使用与临床结果之间的关联,包括机械通风持续时间和急性损伤.
主要方法:
- 在22个儿科心脏重症监护病房的1490名新生儿中进行了一项倾向分数匹配的回顾性研究.
- 对比395名新生儿用腹膜导管放置到628没有,专注于胸腔外科医生协会-欧洲心胸外科协会类别3-5程序.
主要成果:
- 在抽出管的时间或大多数临床结果中没有显著的差异.
- 腹腔导管队列的术后停留时间较长 (22天与17天).
- 没有导管的队列显示,中度至重度急性损伤的发生率高出50% (18%vs12%).
结论:
- 在这个队列中,手术内腹腔导管放置并没有改善整体结果.
- 使用导管观察到更长的住院时间,但急性损伤发生率降低.
- 需要进一步的研究,可能是多中心对照试验,以澄清腹膜导管在特定高风险新生儿中的作用.
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