在接受先天性心脏手术的患者中,手术期间心脏骤停
Morgan L Brown1, Steven J Staffa1, Phillip S Adams2
1Division of Cardiac Anesthesia, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Mass.
JTCVS open
|January 9, 2025
概括
在先天性心脏手术期间的内科心脏骤停是罕见的,但显著增加了患者的死亡率和发病率. 关键预测因素包括先前的心脏骤停,神经学缺陷和紧急手术状态.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 麻醉学 麻醉学
背景情况:
- 内手术性心脏骤停 (ICA) 是先天性心脏手术中的一个关键不良事件.
- 了解它的发病率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:
- 为了描述手术期间心脏骤停的发生率,在患有先天性心脏手术的患者.
- 确定ICA的预测因子及其与外科手术期间发病率和死亡率的关联.
主要方法:
- 对胸部外科医生协会先天性心脏手术数据库的分析.
- 包括92,764个麻醉不良事件数据的病例.
- 单变量和多变量分析以确定预测因素和结果.
主要成果:
- 艾卡的发生率为0.38% (357/92,764名患者).
- 预测因素包括年龄较小,手术前心脏骤停,神经学缺陷,糖尿病,较高的STAT类别,紧急/紧急手术和更长的手术室时间.
- ICA与30天死亡率增加 (14.6%对1.8%) 和术后神经学缺陷,器官衰竭,再手术和心脏导管治疗的更高率有关.
结论:
- 在先天性心脏手术中,手术内心脏骤停是罕见的.
- 然而,它是术后发病率和死亡率增加的重要指标,需要警监测和风险减轻策略.
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