重症监护室监测桃体切除术后阻塞性睡眠呼吸暂停的儿童的情况
Russell Schwartz1, Carolanne Gagnon1, Camille Caron2
1Department of Pediatric Otolaryngology - Head and Neck Surgery, CHU Sainte-Justine, Montreal, QC, Canada.
概括
少数患有阻塞性睡眠呼吸暂停 (OSA) 的儿科患者需要在腺切除术后入住儿科重症监护室 (PICU). 早期的术后氧气需求和呼吸系统收缩预测PICU护理需求.
科学领域:
- 儿科手术 儿科手术
- 睡眠医学 睡眠医学
- 密集护理医学 密集护理医学
背景情况:
- 在腺切除术后,儿科阻塞性睡眠呼吸暂停 (OSA) 患者的术后护理缺乏共识.
- 对于严重的OSA,常规的儿科重症监护室 (PICU) 的入院引起了人们对医疗保健资源利用的担忧.
研究的目的:
- 在接受腺切除术的儿科OSA患者中确定PICU入院的风险因素.
- 评估PICU护理的必要性,以优化资源.
主要方法:
- 对112名确诊OSA的儿科患者进行了回顾性队列研究,这些患者接受了腺切除术.
- 对手术前,手术内和早期术后变量的分析.
- 在PICU级护理的定义中,包括呼吸支 (输入管,通风,高流量鼻管).
主要成果:
- 只有11.6%的患者因呼吸道并发症需要PICU级护理.
- 没有任何手术前或手术内因素预测PICU入院.
- 早期术后补充氧气需求和呼吸收缩是显著的预测因素 (分别为OR=6.7和OR=27.4).
- 大多数 (11/13) 的升级呼吸道测量是在术后4小时内发生的.
结论:
- 小儿OSA患者的一小部分需要在腺切除术后获得PICU护理.
- 早期的术后呼吸道症状是PICU升级的关键指标.
- 小儿OSA患者最初可以在ICU外进行安全监测.
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