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在患有先天性心脏病的儿童中,通过三种非侵入性技术监测周围手术的血液动力学参数:一项前性研究

Xiaoyu Xiong^1,2,3,4,5, Feng Xu^1,2,3,4,5, Wei Qiu^1,2,3,4,5

¹Department of Pediatric Intensive Care Unit Children's Hospital of Chongqing Medical University Chongqing China.

Pediatric discovery

|July 16, 2025

概括

这项研究比较了先天性心脏病 (CHD) 的儿童的非侵入性血液动力学监测. 平均血管活性无otropic 评分 (VISmea),超声心脏指数 (uCImea) 和电心脏计量心脏指数 (eCImea) 准确预测了不良事件和结果.

科学领域:

儿童心脏病学儿童心脏病学
关键护理医学关键护理医学
生物医学工程生物医学工程

背景情况:

患有先天性心脏病 (CHD) 的儿童需要精确的术后血液动力学监测.
对于儿科患者来说,非侵入性方法是首选的,但它们的比较疗效尚未完全确定.
跨胸腔心声学 (TTE),电心计 (EC) 和血管活性无otropic评分 (VIS) 是潜在的监测工具.

研究的目的:

为了比较TTE,EC和VIS在监测儿科心脏病患者的外科手术期间血液动力学方面的效率.
评估这些非侵入性参数对不良事件 (AE) 的预测值.
评估血液动力学参数与临床结果之间的关联,例如机械通风持续时间和重症监护室停留时间.

主要方法:

一项前性研究涉及74名患有心血管疾病的儿童,他们正在接受TTE,EC和VIS监测.
测量的主要参数包括左心室喷射率 (LVEF),超声波心脏指数 (uCI),电心脏计量心脏指数 (eCI),全身血管阻力指数 (SVRI) 和VIS.
记录和分析了不良事件 (AEs) 和临床结果 (机械呼吸的持续时间,ICU停留时间).

主要成果:

八个参数 (VISmax,VISmea,uCImea,uCImin,eCImea,eCImin,SVRImea,SVRImin) 预测了AEs (p <0.05),除了LVEF之外.
VISmea,uCImea和eCImea显示了最高的准确性 (AUROC>0.9) 和与AE最强的线性关联.
增加VISmea或减少uCImea/eCImea与更长的机械通风持续时间和ICU停留时间相关 (p <0.05).

结论:

大多数TTE,EC和VIS参数有效地反映了儿科慢性心血管疾病中的术后血液动力学.
VISmea,uCImea和eCImea是预测不良事件和结果的最准确和可靠的指标.
来自TTE的LVEF不是这个队列中AE的可靠预测指标.

关键词:

遗传性心脏病是一种先天性心脏病.超声心电图 (Echocardiography) 是一种心声回声仪.电动心脏计量电动心脏计量血液动力学血液动力学血管活性异型评分 (vasoactive inotropic score) 是一个指标.

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