患有癌症的儿童中枢静脉氧和度
Nadja Hawwa Vissing1, Kia Hee Schultz Dungu1, Frederik Mølkjær Andersen2
1From the Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet.
Pediatric emergency care
|August 14, 2024
概括
患有癌症的儿童中枢静脉和度 (ScvO2) 通常低于典型的正常范围. 这一发现对于准确评估这种脆弱人群的败血症休克至关重要.
科学领域:
- 儿科瘤学 儿科瘤学
- 临界护理医学 临界护理医学
- 临床化学 临床化学
背景情况:
- 中枢静脉和度 (ScvO2) 是指导小儿败血症休克复苏的关键指标.
- 已确定的正常ScvO 2范围 (0.70-0.80) 可能不适用于患有癌症的儿童,这些儿童容易发生败血症,并且经常有中央静脉导管.
- 在这个人群中了解基线ScvO 2对于准确的临床评估至关重要.
研究的目的:
- 在接受癌症治疗的临床稳定的儿童中确定正常的中央静脉和 (ScvO2) 值.
- 在这个队列中调查ScvO 2,血红蛋白和乳酸盐水平之间的关联.
- 在怀疑感染性休克的儿科癌症患者中,为ScvO 2的解释提供信息.
主要方法:
- 在第三级儿科血液学/瘤学门诊所进行的前性临床研究.
- 在例行检查期间,从68名患有癌症的儿童 (0-17.9岁) 采集了血液样本.
- 对ScvO2,血红蛋白和乳酸水平的分析.
主要成果:
- 预测的ScvO 2平均值为0.67 (95% CI:0.56至0.78).
- 很大一部分 (69%的样本,71%的患者) 的ScvO2低于0.70.0的常规下限.
- ScvO 2与血红蛋白 (P < 0.001) 有显著的积极关联,但与年龄,性别或乳酸无关.
结论:
- 临床稳定的患有癌症的儿童经常呈现ScvO 2水平低于标准参考范围.
- 这表明,在这个人群中,潜在的基线内在ScvO 2可能较低.
- 医疗保健提供者应在评估儿科癌症患者的败血症休克时考虑这些发现,倡导量身定制的诊断方法.
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