在患有先天性心脏病的儿科患者进行非心脏手术的内科手术心脏事件:分析大型多中心注册表
Viviane G Nasr1, Michael Kuntz2, Vannessa Chin3
1Viviane G. Nasr, M.D., M.P.H.: Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Anesthesiology
|October 3, 2025
概括
患有先天性心脏病 (CHD) 的儿科患者在非心脏手术期间面临5.2%的手术内心脏事件的风险. 严重的心脏病,紧急手术和呼吸道疾病显著增加这种风险.
科学领域:
- 心脏病学 心脏病学
- 儿科麻醉学 儿科麻醉学
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 在非心脏手术过程中,先天性心脏病 (CHD) 患者患并发症的风险较高.
- 以前的研究往往依赖于有限的单一机构数据或仅关注死亡率的国家数据库.
- 建立了一个多机构注册表,以调查儿科心脏病患者的手术内心脏事件.
研究的目的:
- 确定非心脏手术中患有心脏病的儿科患者手术期间心脏事件的发生率.
- 确定与这些心脏事件相关的患者特异性和程序相关的风险因素.
主要方法:
- 一项多机构注册研究确定了2021年接受非心脏手术的儿科患者 (出生至21岁) 患有心脏病.
- 测量的主要结果是手术内心脏事件的发生,定义为血液动力学不稳定,心脏骤停或肺高血压危机.
- 来自7个中心的数据包括4,343名独特患者的6,455次手术.
主要成果:
- 在5.2%的手术中发生了手术内心脏事件 (335/6,455),影响了296名患者.
- 低血压是最常见的事件 (4.9%),其次是心脏骤停 (0.2%).
- 风险因素包括早产,胃肠道/呼吸系统疾病,手术前的呼吸系统支持,同时出现的呼吸系统疾病,以及严重或严重的慢性心血管疾病.
结论:
- 患有严重心脏病的儿科患者接受紧急或外科手术的非心脏手术,患有手术内心脏事件的风险增加,包括血液动力学不稳定性.
- 确定的风险因素对于制定有针对性的风险减轻策略至关重要.
- 这项研究强调了在这个脆弱人群中需要仔细的术后管理.
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