小儿气管切除术后的支气管肺形和与通风相关的结果
Stephen R Chorney1,2, Dylan R Beams1, Arushii Nadar1
1Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Pediatric pulmonology
|September 13, 2024
概括
支气管肺形 (BPD) 增加了儿童的通风和气管切除术的持续时间. 然而,许多患有BPD的患者最终会停止使用呼吸机,并被解通道,肺高血压与死亡率增加有关.
科学领域:
- 儿科肺病学 儿科肺病学
- 关键护理医学 关键护理医学
- 新生儿科学 新生儿科学
背景情况:
- 支气管肺功能障碍症 (BPD) 是婴儿的慢性肺部疾病.
- 肺高血压 (PH) 是一种严重的并发症,可以影响患有BPD的儿童.
- 气管切除术通常是这些患者长时间机械呼吸所必需的.
研究的目的:
- 确定患有BPD和PH的儿科患者的呼吸器释放和气管切除术解管的时间.
- 为了比较BPD和没有BPD的儿童在气管切除术后的结果.
- 为了确定与气管切除术后死亡率相关的因素.
主要方法:
- 在2015年至2021年期间进行气管切除术的儿童 (<18岁) 的前性队列研究.
- 纳入标准:气管切除术的位置;收集关于BPD和PH诊断的数据.
- 主要结局:通风器释放的时间,脱管,或通过气管切除术死亡.
主要成果:
- 303名儿童中有42%患有BPD,更年轻,更有可能患PH.
- 患有BPD的儿童有更长的通风时间 (2.9年对1.9年) 和脱时间 (3.4年对1.8年).
- 随着时间的推移,BPD并没有显著延长呼吸器释放或脱管;PH与死亡率增加相关 (aHR=1.99),而BPD与死亡率降低相关 (aHR=0.38).
结论:
- BPD与更长的通风和气管切除术持续时间有关,但不会阻止最终的断奶和断管.
- 肺高血压,而不是BPD,与气管切除术后的死亡率增加有关.
- 在患有BPD和PH的儿童中,气管切除术的结果需要仔细考虑并发症.
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