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Updated: Sep 11, 2025

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Published on: January 17, 2011
在小儿心脏手术后的桌上输出管:系统性审查.
Vanessa Tapioca1, Lucas Caetano2, Tathiane Gibicoski3
1Department of Medicine, Bahiana School of Medicine and Public Health, Salvador, Brazil.
在儿科心脏外科手术中,桌上输管可能会降低再输管率和停留时间. 然而,由于潜在的偏见和异质性,需要更多高质量的研究来确认安全性和益处.
科学领域:
- 儿科心脏手术 儿科心脏手术
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
背景情况:
- 在儿童心脏外科手术中,越来越多地考虑在桌面上的输出管,以缩短通风时间.
- 仍然存在关于再输管风险,患者选择和结果变异性的担忧.
研究的目的:
- 在儿童心脏外科手术中系统地审查有关桌上与桌外输出管的有效性和安全性的文献.
- 主要结局:再化率,死亡率,ICU和住院时间 (LOS).
- 二次结局:手术后动脉pH值,乳酸盐和PaCO2.
主要方法:
- 在MEDLINE,科克伦图书馆,科学网络和Embase的系统文献搜索到2025年1月.
- 包括随机对照试验 (RCT) 和对接受心血管手术的儿科患者 (<18岁) 的观察性研究.
- 两个独立的审查员进行了研究选,质量评估和数据提取.
主要成果:
- 包括29项研究 (2项RCT,27项观察性) 涉及9070名患者.
- 在大多数研究中,桌上输出与更低的再输入率,更短的ICU和医院LOS以及更好的术后血液气体概况有关.
- 死亡率相似;然而,在观察性研究中,偏差风险较高.
结论:
- 选择偏差是由于大多数研究的观察性质和临床医生基于桌上输出管的决定而存在的.
- 研究中的高度异质性限制了最终结论和元分析的可行性.
- 精心设计的RCT对于确认桌上输出管的好处和安全性以及指导患者选择至关重要.
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