对儿童低血压干预的单一中心描述性分析:回顾性队列研究
Christopher S McLaughlin1, Vikas N O'Reilly-Shah2,3, L Daniela Smith1
1Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Paediatric anaesthesia
|August 11, 2025
概括
儿科手术内低血压管理因年龄而异,较小儿童的血压干预门较低. 专和基是常见的治疗方法,突出了对标准化儿科护理指导方针的需要.
科学领域:
- 麻醉学 麻醉学
- 儿科重症监护 儿科重症监护
- 血液动力学监测 血液动力学监测
背景情况:
- 由于与年龄相关的生理变异性,儿科手术内血液动力学管理缺乏标准化的目标.
- 术内低血压的不一致定义导致了儿科手术的实践变化.
研究的目的:
- 为了确定特定年龄的血压值,在儿科非心脏手术期间引发临床干预.
- 确定用于治疗儿科患者手术内低血压的最常见干预措施.
主要方法:
- 一项回顾性观察性研究分析了2015-2023年37,958份儿科麻醉记录 (年龄<18岁).
- 患者被分为婴儿 (0-12个月),学前 (1-6岁),儿童 (7-12岁) 和青少年 (13-17岁) 的类别.
- 干预包括血管抑制剂 (以弗得林,上腺素,上腺素,上腺素,血管压素) 和5%的白蛋白;分析了与干预相关的最低平均动脉压.
主要成果:
- 与干预相关的中位动脉压随年龄而下降:36 mmHg (婴儿),44 mmHg (学龄前儿童),51 mmHg (儿童) 和57 mmHg (青少年).
- 最常见的干预措施是5%的白蛋白和烯酸.
- 干预率低于成年人报告的干预率.
结论:
- 在儿科患者的手术内低血压管理显示,在年轻年龄组的干预值较低.
- 血管内体积扩张 (5%的白蛋白) 经常用于婴儿,而血管压缩剂在老年儿童中很常见.
- 需要多中心研究来建立标准化的儿科干预门,并评估其临床影响.
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