静态肺扩张在儿童心肺旁路术后对肺功能的影响
Yu Huang1,2, Guolin Lu1,2, Zengchun Wang1,2
1Fujian Children's Hospital, Fujian Branch of Shanghai Children's Medical Center, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian 350014, China.
Heliyon
|July 23, 2024
概括
静态肺部扩张在心肺绕道期间改善氧化和肺功能,在儿童进行腹腔隔膜缺陷修复. 这种肺部保护策略增强了心脏手术后的肺部结果.
科学领域:
- 儿科心脏手术 儿科心脏手术
- 呼吸系统生理学 呼吸系统生理学
- 关键护理医学 关键护理医学
背景情况:
- 儿童心脏手术,特别是心室隔膜缺陷 (VSD) 修复,往往导致术后肺损伤.
- 心肺绕道 (CPB) 可以加剧肺功能障碍,影响氧化和气体交换.
- 肺部保护性通风策略对于减轻这些不良影响至关重要.
研究的目的:
- 评估肺保护性通风策略的影响,特别是静态肺扩张带有正气道压力,在CPB期间对儿科患者的肺功能的影响.
- 为了比较静态肺扩张与常规通风停止对心脏手术后氧化和呼吸指数的影响.
- 评估在CPB期间维持肺扩张在预防术后肺损伤方面的有效性.
主要方法:
- 一项随机对照试验,涉及48名儿科患者 (年龄为1-3岁),他们首次接受VSD的CPB心脏手术.
- 患者被分为一个实验组 (n=30) 在CPB期间接受静态肺扩张 (5 cmH2O正气道压力) 和一个控制组 (n=18) 进行常规通风停止.
- 手术后测量了肺功能,包括动脉氧气局部压力,呼吸指数和氧化指数.
主要成果:
- 在CPB期间静态肺膨胀与5cmH2O正气道压力显著增加了VSD儿童的动脉氧部分压力.
- 与对照组相比,实验组显示呼吸指数下降和氧化指数增加.
- 这些发现表明,在CPB期间静态肺扩张后,肺氧化和功能得到改善.
结论:
- 静态肺部扩张,持续的气道压力为5cmH2O,是儿童VSD修复中CPB期间有效的肺部保护策略.
- 这一策略改善了手术后的肺氧化和功能,而不是简单地终止机械通风.
- 在CPB期间实施静态肺扩张可以减轻肺损伤,并在接受心脏手术的儿童中加强恢复.
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