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早期输管受伤儿童的精神状态改变的早期输管
James A Meltzer1, Anna Liveris2, Stephen M Blumberg1
1Department of Pediatrics, Division of Emergency Medicine, Jacobi Medical Center, Bronx, New York.
The Journal of emergency medicine
|September 17, 2025
概括
对于格拉斯哥昏迷尺度 (GCS) ≤8的受伤儿童,早期输管治疗并没有降低死亡率或不良结果. 这项研究表明,目前的指导方针可能需要对儿科创伤患者进行重新评估.
科学领域:
- 儿科急救医学 儿科急救医学
- 创伤外科 手术 创伤外科
- 临床结果研究研究
背景情况:
- 目前的复苏指南建议在格拉斯哥昏迷尺度 (GCS) ≤8.8的创伤患者早期输管.
- 支持这一建议的证据有限,特别是在儿科患者群体中.
研究的目的:
- 调查受伤儿童 (GCS ≤8) 进入急诊室 (ED) 的早期输管是否与降低发病率和死亡率有关.
- 为了比较在ED到来后1小时内被直管的儿童与后来被直管的儿童之间的结果.
主要方法:
- 从国家创伤数据库 (2017-2021) 来对受伤儿童 (<18岁) 具有GCS ≤8的回顾性分析.
- 根据输管时间对患者进行分类:早期 (在ED到达1小时内) 和不早期.
- 倾向性得分反向概率权重被用于控制混因素.
主要成果:
- 在早期和晚期输管组之间没有观察到24小时死亡率或功能性结果差的风险的显著差异.
- 早期输管与30天死亡风险的小但统计学上显著增加有关.
- 该研究分析了6698名符合条件的患者,来自25355.5人的更大队列.
结论:
- 这些发现挑战了在所有受伤儿童中早期输内管道的普遍建议,其GCS得分≤8.8.
- 需要进一步的研究,以根据特定的临床因素来完善儿科创伤患者的输管协议.
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