在小儿微喉镜和支气管镜检查后出现术后呼吸系统事件的危险因素
Jennifer M Siu1, Samantha Goh1, Justin T Levinsky2
1Department of Otolaryngology - Head and Neck Surgery, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
概括
在微喉腔镜和支气管镜检查 (MLB) 后,识别患有呼吸系统事件高风险的儿科患者至关重要. 年龄1-2岁,心血管疾病和住院手术等危险因素有助于量身定制术后护理,减少ICU利用率.
科学领域:
- 儿科耳鼻喉科 儿科耳鼻喉科
- 儿科麻醉学 儿科麻醉学
- 儿科重症监护 儿科重症监护
背景情况:
- 术前风险分层优化了小儿微喉镜和支气管镜 (MLB) 术后的术后处置.
- 识别接受MLB的高风险患者可以改善资源配置和患者的治疗结果.
研究的目的:
- 为了确定术前的风险因素,术后的呼吸系统事件需要升级的护理后儿科MLB.
- 确定接受MLB的高风险患者的一个亚群.
主要方法:
- 在2017-2023年期间,对420名接受MLB治疗的患者进行了回顾性队列研究.
- 多变量逻辑回归分析,以确定手术后呼吸系统事件的独立风险因素.
- 主要结局:需要升级护理的呼吸事件 (例如,氧气升级,ICU转移,PEW得分>5).
主要成果:
- 超过一半 (54.5%) 的患者经历了需要升级护理的事件.
- 确定了独立的风险因素:年龄为1-2岁,心血管疾病,GERD,ASA IV,MLB带有膜造形术,住院手术,以及手术时间≥180分钟.
- 具体事件包括氧气升级 (35.2%) 和PEW评分>5 (37.4%).
结论:
- 术前风险因素,如年龄,并发症 (心血管疾病,GERD),ASA状态,手术复杂性 (超造形) 和手术因素预测MLB后的术后呼吸事件.
- 根据已识别的风险因素来定制术后处置,可以优化资源使用,并确保适当的患者监测.
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