在心脏手术后,对新生儿和婴儿的输出失败的前性评估
Amy E Hanson1, Jeremy L Herrmann2, Samer Abu-Sultaneh1
1Division of Critical Care, Department of Pediatrics, Indiana University School of Medicine, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, USA.
World journal for pediatric & congenital heart surgery
|October 3, 2024
概括
心脏手术后婴儿的输出失败与不同的原因有关,取决于时间. 体重和正极呼气压 (PEEP) 可能是防止再输管的可修改因素.
科学领域:
- 儿科心脏手术 儿科心脏手术
- 新生儿重症监护中心
- 呼吸系统管理 呼吸系统管理
背景情况:
- 输出失败是心脏手术后新生儿和幼儿的严重并发症.
- 识别输出失败的原因和预测因素对于改善患者的治疗结果至关重要.
研究的目的:
- 确定心脏手术后新生儿和幼儿的输出失败发生率,病因和临床特征.
- 要区分早期和晚期输出管失败的原因.
主要方法:
- 在一个单一的中心进行了前性观察研究.
- 包括132名接受心脏手术的婴儿 (≤180天),其中至少有一次试图输出输出管.
- 患者根据成功的输出管与失败 (在72小时内重新输入管) 进行了分类.
主要成果:
- 8.3%的患者 (132人中11人) 经历了输出失败,平均重新输入时间为25.5小时.
- 早期失效 (<12小时) 与上呼吸道阻塞/呼吸暂停有关;晚期失效 (12-72小时) 与肺部疾病或心脏功能障碍有关.
- 与输出失败显著相关的因素包括遗传异常,相对于基线的体重较低,以及使用正极呼气压 (PEEP) >5cmH2O.
结论:
- 在这个易受伤害的人群中,早期与晚期输出失败的病理生理学不同.
- 排卵时的相对重量和PEEP水平是未来研究的潜在可修改目标,以减少排卵失败率.
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