术后输血动脉血气可预测患有先天性心脏病的儿童的再输血
Andrew G Miller1,2,3, Katherine Cashen1, Elizabeth J Thompson1,4
1Mr. Miller, Dr. Cashen, Dr. Thompson, Dr. Zakhar, Dr. Allareddy, and Dr. Rotta are affiliated with the Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, North Carolina, USA.
患有心脏病的儿童体内输血后的酸性血症会使再输血的风险增加三倍. 虽然大多数儿童不需要重新输管,但监测酸平衡对于儿科心脏重症监护病房患者至关重要.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 关键护理医学 关键护理医学
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 机械通风在患有心脏病的儿童中很常见.
- 动脉血液气体 (ABG) 分析术后化是标准的做法.
- 有限的数据存在于这个人群中,对 postextubation ABGs 的实用性.
研究的目的:
- 为了调查儿科心脏病患者的术后酸血和再输管之间的关联.
- 为了确定机械通风后与再输管相关的因素.
主要方法:
- 在2022年6月至2024年12月期间,对718名儿科心脏重症监护病房 (PCICU) 的患者进行了回顾性评估.
- 血酸性疾病的定义是动脉pH值<7.35.
- 主要结局:在48小时内重新灌输;次要结局:非侵入性呼吸辅助 (NRS) 持续时间和住院时间.
主要成果:
- 酸血症存在于13%的受试者中 (91/718).
- 患有酸血症的受试者具有更高的再灌输概率 (21%与7.3%) 和更长的NRS持续时间.
- 与再输管相关的因素包括酸血症 (OR 2.8),心室辅助装置的放置 (OR 30.2) 和更高的输管外置准备测试 (ERT) 呼吸频率 (OR 1.03).
结论:
- 静脉注射后的酸性血症与心脏病患者儿童的再静脉注射风险增加了三倍.
- 尽管风险增加了,但80%的酸血症患者不需要重新输管.
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