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支气管阻断剂与内支气管输管在接受单肺通风的幼儿:一个多中心的回顾性队列研究
Christopher S McLaughlin1, Anusha Samant1, Amit K Saha1
1From the Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
Anesthesia and analgesia
|September 13, 2024
概括
在接受胸腔手术的幼儿中,与支气管阻塞剂相比,内支气管输管显示出关键气道并发症的风险略高. 需要进一步的研究来证实这些发现,以改变实践.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 胸部外科手术 胸部外科手术
- 关键护理医学 关键护理医学
背景情况:
- 在儿科胸部手术中,单肺通风存在重大风险.
- 常见的通风方法包括内支气管插管和支气管阻塞剂.
- 这项研究调查了幼儿中这两种方法之间的呼吸道并发症率.
研究的目的:
- 为了比较儿科患者内支气管输入管和支气管阻塞剂之间的呼吸道并发症的发生率.
- 确定胸部手术期间每种通风方法相关的潜在风险.
主要方法:
- 对多中心期经期结果组数据库 (2004-2022) 的回顾性分析.
- 包括接受单肺通风的儿科患者 (2个月至3岁).
- 手动审查气道笔记和自由文本评论,以确定中度和关键气道并发症.
- 倾向性得分匹配分析,以比较输管方法之间的并发症率.
主要成果:
- 704名患者被纳入分析.
- 两组之间中度呼吸道并发症没有显著差异 (8.3%与10.8%,P=.281).
- 在未经调整的分析中,临界气道并发症在内支气管输管时显著增加 (6.3%对1.9%,P=.008).
- 倾向匹配的分析显示,内支气管输管时,关键并发症的风险略有增加 (5.8%对2.1%,P=.035).
结论:
- 与小孩的支气管阻塞剂相比,内支气管输管可能与关键气道并发症的风险略高.
- 这些发现表明,支气管阻塞剂在减少严重的气道事件方面具有潜在的益处.
- 建议进行进一步的前性研究,以指导临床实践建议.
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