优化恢复:儿童心脏手术患者的早期与延迟的胸管切除:一个随机对照试验
Abdulraouf M Z Jijeh1,2,3, Ghassan A Shaath1,2,3, Sameh R Ismail1,2,3
1Department of Cardiac Sciences, Division of Pediatric Cardiac Intensive Care, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.
Critical care explorations
|June 4, 2025
概括
在儿科心脏外科手术中提前切除胸管可显著缩短胸管的持续时间,而不会增加并发症. 这种基于证据的方法优化了重症监护室 (ICU) 的资源使用和患者舒适度.
科学领域:
- 儿科心脏手术 儿科心脏手术
- 胸部手术的结果 胸部手术的结果
- 重症监护病房管理人员管理重症监护病房.
背景情况:
- 小儿心脏手术后,胸管排水是标准的.
- 长时间的胸管使用时间会影响患者的舒适度和资源利用率.
研究的目的:
- 评估早期胸管切除方案的安全性和有效性.
- 确定早期切除是否能减少胸腔管的持续时间,而不会增加儿科心脏手术患者的并发症.
主要方法:
- 一个单一中心随机对照试验,涉及215名儿科患者.
- 患者被随机分配到早期 (在8小时内排水量<6毫升/千克) 或晚期 (24小时评估) 的胸管切除.
- 主要结局是胸腔管的持续时间;次要结局包括ICU停留,通风时间,住院和并发症.
主要成果:
- 早期切除组 (3天) 的胸管平均持续时间明显短于晚期切除组 (4.9天).
- 液体再积累和肺胸部的发生率很低,在各组之间相似.
- 没有患者需要重新插入胸腔管;ICU和住院时间相似.
结论:
- 早期的胸管切除方案有效地减少了儿科心脏手术中的胸管持续时间.
- 这种方法是安全的,没有增加并发症,支持其采用.
- 提前移除可提高患者的舒适度,并优化ICU资源利用率.
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