接受非心脏手术的家庭通风儿童的特征和结果
Jia Liu1,2, Anna Kordun3, Steven J Staffa3
1Divisions of Anesthesiology, Pain, and Perioperative Medicine.
Hospital pediatrics
|August 22, 2024
概括
患有慢性呼吸衰竭 (CRF) 需要家庭通风的儿童经常接受手术. 呼吸道外机械通风 (呼吸道/通风) 的依赖与更高的资源使用和再接收风险有关,需要进一步研究以优化护理.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 儿科重症监护医学 儿科重症监护医学
- 儿科手术 儿科手术
背景情况:
- 患有慢性呼吸衰竭 (CRF) 和家庭呼吸机依赖的儿童代表了需要手术干预的越来越多的人口.
- 这些患者往往有复杂的医疗需求,需要专门的术后护理.
- 了解这一群体中手术程序的频率和结果对于优化资源配置和患者管理至关重要.
研究的目的:
- 为了确定CRF和家庭呼吸机依赖的儿童接受手术的频率.
- 描述这些患者的周围手术特征和结果.
- 在这个脆弱群体中确定与30天再接收相关的因素.
主要方法:
- 对2013年至2019年期间接受非心脏手术的CRF和家庭呼吸机依赖患者的回顾性队列研究.
- 描述性统计数据用于患者和程序特征.
- 单变量和多变量分析评估了与30天再入院相关的因素.
主要成果:
- 416名患者接受了1623项手术,51%的人使用过轨道机械通风 (气管/通风).
- 气管/通风患者较年轻,更复杂 (ASA状态),并且与双层阳性气道压力 (BiPAP) 用户相比,在ICU停留时间更长 (中位数为5天而不是2天).
- 整体30天再接收率为12%. 慢性肺病和气管/通风依赖独立地与增加的再入院几率有关.
结论:
- 患有CRF的儿童经常使用手术和麻醉服务,气管/通风器使用者表现出更高的资源利用率.
- 虽然死亡率很低,但频繁的再接收表明需要进一步调查潜在的诊断和技术依赖.
- 优化这些复杂的儿科手术患者的资源利用和结果需要持续研究.
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