手术前的高流量鼻和机械通风降低了上腔肺连接后的生存率
Sydney Elizer1, Deepti P Bhat1, Daniel A Velez1
1Center for Heart Care, Phoenix Children'S Hospital, 1919 E Thomas Rd, Phoenix, AZ, 85016, USA.
手术前的高流量鼻腔管或机械通风会对上腔肺连接手术后的存活率产生负面影响. 在手术前需要呼吸支的患者在1年和5年内无移植生存率明显降低.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 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:
- 上腔肺连接 (SCPC) 是针对单心室先天性心脏病的一种息性手术程序.
- 手术前的呼吸支可能会影响大心脏手术后的结果.
研究的目的:
- 评估手术前高流量鼻腔管 (HFNC) 或机械通风对接受上腔肺连接手术的患者手术后结果的影响.
主要方法:
- 一个单一中心的回顾性审查包括269名接受SCPC的儿科患者.
- 患者被分为三组:机械通风,高流量鼻 (HFNC) 和控制 (室内空气或低流量鼻).
- 分析的结果包括30天和1/5年生存率,无移植生存率,停留时间和输管持续时间.
主要成果:
- 44名患者需要手术前的HFNC,17名患者需要机械通风.
- 所有群体的30天生存率都很高.
- 与HFNC (84%) 和对照 (95%) 组相比,机械通风组的1年无移植生存率 (46%) 显着较低 (p < 0.01).
- 五年无移植生存率呈现出类似的趋势 (20%对78%对90%,p<0.01).
- 机械通风患者的整体存活率较差,住院时间较长,术后输管时间较长.
结论:
- 手术前的呼吸辅助,特别是机械通风,与高层腔肺连接后的长期存活率较差有关.
- 与机械通风相比,高流量鼻支可能是一个不太有害的手术前呼吸策略.
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