在下分心后,哪些因素会影响安全的床边输出?
Cory M Resnick1,2, Andrew J Deek3, Ryan Caprio4
1Harvard School of Dental Medicine and Harvard Medical School, Boston, MA, USA.
概括
在Robin序列 (RS) 的婴儿进行下分心骨质生成 (MDO) 手术后重新灌输是罕见的. 大多数婴儿可以在重症监护室安全地被抽管,尽量减少资源和简化护理.
科学领域:
- 儿科手术 儿科手术
- 面外科手术 面外科手术
- 新生儿重症监护中心
背景情况:
- 部分散骨质生成 (MDO) 是一种用于治疗罗宾序列 (RS) 婴儿的手术程序.
- 在RS的婴儿中,MDO之后没有标准化的输出管的协议,导致护理的变化.
- 确定影响输出管成功的因素对于优化患者的治疗结果和资源配置至关重要.
研究的目的:
- 为了确定在MDO之后RS的婴儿在输出管后24小时内重新输入管的频率.
- 为了确定与再输管或输管后呼吸事件风险增加相关的因素.
- 在这个患者群体中建立计划MDO后输出管的最佳条件.
主要方法:
- 在2013年至2021年期间接受MDO的RS婴儿的回顾性观察研究.
- 数据收集包括患者的人口统计,并发病,手术细节和后化呼吸事件.
- 主要结局:在24小时内重新灌输;次要结局:氧和率<95%.
主要成果:
- 52名 (1.9%) 婴儿中有1名需要重新输管. 四十一个 (78.8%) 经历过渡性氧气不和,用氧气或CPAP进行管理.
- 术后呼吸道事件的危险因素包括斯蒂克勒综合征,并发症 (肌肉骨,神经,内分泌),低出生体重和高手术前AHI.
- 手术后平均3.6天发生了输出管.
结论:
- 在RS的婴儿中,MDO后的再输管在RS的婴儿中很少发生.
- 较小的氧气脱是常见的,但可以通过标准的ICU协议来管理.
- 大多数RS的婴儿可以在MDO后的ICU中安全地进行输管,从而减少资源利用和医院成本.
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