Anesthesiology:围手术期肺超声在小儿心脏手术中的应用:一项随机、对照研究

2018-03-18 雷涓 “罂粟花”微信号

小儿心脏病患者存在围手术期呼吸功能不全的风险。本研究的目的是评估围术期肺部超声检查在小儿心脏手术中的效用。

背景与目的:小儿心脏病患者存在围手术期呼吸功能不全的风险。本研究的目的是评估围术期肺部超声检查在小儿心脏手术中的效用。

方法:在这项随机对照试验中,接受心脏手术的儿童(5岁或以下)被分配到对照组(n = 61)或干预(n = 61)组。对照组在手术结束时和手术后6-12小时仅接受肺部超声检查。干预组在麻醉后、手术结束和术后6~12h根据超声检查结果,进行肺超声检查和超声引导下的肺复张。主要结果是术中和术后低氧饱和度以及术后肺部并发症。在主要的结果分析中多重比较被修正(P≤0.017)。

结果:在分析中包括的120名儿童中,术后低氧饱和度(64%对27%; P <0.001;比值比[OR],0.210; 95 %CI,0.097至0.456)在对照组发生更多。术中低氧饱和度的发生率(36%vs. 19%; P = 0.033; OR,0.406; 95%CI,0.176?0.939)和术后肺部并发症(12%vs. 3%; P = 0.093; OR,0.271; 95 %CI,0.054至1.361)两组之间相似。干预组的肺超声评分优于对照组。对照组机械通气时间长于干预组(38±43vs26±25h;平均差异的95%CI,0?25; P = 0.048)。

结论:围手术期肺部超声检查后,超声引导下的人工操作有助于减少儿科心脏病患者的术后低氧饱和度事件并缩短机械通气时间。

原始出处:

Song IK, Kim EH, Lee JH,et al. Utility of Perioperative Lung Ultrasound in Pediatric Cardiac Surgery: A Randomized Controlled Trial. Anesthesiology. Apr,2018 ;128(4):718-727. doi: 10.1097/ALN.0000000000002069.

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    2018-10-11 TZF0804
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    2018-09-11 amyloid
  5. [GetPortalCommentsPageByObjectIdResponse(id=1934207, encodeId=0ebf193420ee1, content=<a href='/topic/show?id=6f4182325c8' target=_blank style='color:#2F92EE;'>#肺超声#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82325, encryptionId=6f4182325c8, topicName=肺超声)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0041445, createdName=TZF0804, createdTime=Thu Oct 11 12:50:00 CST 2018, time=2018-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2053820, encodeId=fa2220538200c, content=<a href='/topic/show?id=8f5a54442a1' target=_blank style='color:#2F92EE;'>#手术期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54442, encryptionId=8f5a54442a1, topicName=手术期)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/WQ1WyMBGic8d2fKdCe6Cm3vaRh4X8YnlumYndC46iagNCBl9Df8RtoCaQchnFtZldHUctGJjsgsyutUlu8vPq6yQ/132, createdBy=97862500016, createdName=ms3117646317107274, createdTime=Sun Jul 22 13:50:00 CST 2018, time=2018-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2051099, encodeId=ad872051099fb, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Mon Sep 24 06:50:00 CST 2018, time=2018-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1775389, encodeId=bfdc1e75389d3, content=<a href='/topic/show?id=937d46650bf' target=_blank style='color:#2F92EE;'>#对照#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46650, encryptionId=937d46650bf, topicName=对照)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ae138776909, createdName=amyloid, createdTime=Tue Sep 11 01:50:00 CST 2018, time=2018-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588322, encodeId=fd161588322dc, content=<a href='/topic/show?id=1cb8e014e0' target=_blank style='color:#2F92EE;'>#ESI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7014, encryptionId=1cb8e014e0, topicName=ESI)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4f817593223, createdName=skhzy, createdTime=Tue Mar 20 01:50:00 CST 2018, time=2018-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=297422, encodeId=d3f829e42237, content=对临床病人大有益处.多多推广, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK29w9r0upRgxUXHNhe7bd3VxHnhBSpibMbKOjtX92zXr78SkuZfUNuADrjHiaw6uibZaEYjh9cJLzew/132, createdBy=261e1682638, createdName=1de3b290m83(暂无匿称), createdTime=Sun Mar 18 14:34:15 CST 2018, time=2018-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=297400, encodeId=4cc929e4007e, content=学习了.不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Sun Mar 18 11:40:26 CST 2018, time=2018-03-18, status=1, ipAttribution=)]
    2018-03-20 skhzy
  6. [GetPortalCommentsPageByObjectIdResponse(id=1934207, encodeId=0ebf193420ee1, content=<a href='/topic/show?id=6f4182325c8' target=_blank style='color:#2F92EE;'>#肺超声#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82325, encryptionId=6f4182325c8, topicName=肺超声)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0041445, createdName=TZF0804, createdTime=Thu Oct 11 12:50:00 CST 2018, time=2018-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2053820, encodeId=fa2220538200c, content=<a href='/topic/show?id=8f5a54442a1' target=_blank style='color:#2F92EE;'>#手术期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54442, encryptionId=8f5a54442a1, topicName=手术期)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/WQ1WyMBGic8d2fKdCe6Cm3vaRh4X8YnlumYndC46iagNCBl9Df8RtoCaQchnFtZldHUctGJjsgsyutUlu8vPq6yQ/132, createdBy=97862500016, createdName=ms3117646317107274, createdTime=Sun Jul 22 13:50:00 CST 2018, time=2018-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2051099, encodeId=ad872051099fb, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Mon Sep 24 06:50:00 CST 2018, time=2018-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1775389, encodeId=bfdc1e75389d3, content=<a href='/topic/show?id=937d46650bf' target=_blank style='color:#2F92EE;'>#对照#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46650, encryptionId=937d46650bf, topicName=对照)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ae138776909, createdName=amyloid, createdTime=Tue Sep 11 01:50:00 CST 2018, time=2018-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588322, encodeId=fd161588322dc, content=<a href='/topic/show?id=1cb8e014e0' target=_blank style='color:#2F92EE;'>#ESI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7014, encryptionId=1cb8e014e0, topicName=ESI)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4f817593223, createdName=skhzy, createdTime=Tue Mar 20 01:50:00 CST 2018, time=2018-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=297422, encodeId=d3f829e42237, content=对临床病人大有益处.多多推广, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK29w9r0upRgxUXHNhe7bd3VxHnhBSpibMbKOjtX92zXr78SkuZfUNuADrjHiaw6uibZaEYjh9cJLzew/132, createdBy=261e1682638, createdName=1de3b290m83(暂无匿称), createdTime=Sun Mar 18 14:34:15 CST 2018, time=2018-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=297400, encodeId=4cc929e4007e, content=学习了.不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Sun Mar 18 11:40:26 CST 2018, time=2018-03-18, status=1, ipAttribution=)]
    2018-03-18 1de3b290m83(暂无匿称)

    对临床病人大有益处.多多推广

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1934207, encodeId=0ebf193420ee1, content=<a href='/topic/show?id=6f4182325c8' target=_blank style='color:#2F92EE;'>#肺超声#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82325, encryptionId=6f4182325c8, topicName=肺超声)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0041445, createdName=TZF0804, createdTime=Thu Oct 11 12:50:00 CST 2018, time=2018-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2053820, encodeId=fa2220538200c, content=<a href='/topic/show?id=8f5a54442a1' target=_blank style='color:#2F92EE;'>#手术期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54442, encryptionId=8f5a54442a1, topicName=手术期)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/WQ1WyMBGic8d2fKdCe6Cm3vaRh4X8YnlumYndC46iagNCBl9Df8RtoCaQchnFtZldHUctGJjsgsyutUlu8vPq6yQ/132, createdBy=97862500016, createdName=ms3117646317107274, createdTime=Sun Jul 22 13:50:00 CST 2018, time=2018-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2051099, encodeId=ad872051099fb, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Mon Sep 24 06:50:00 CST 2018, time=2018-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1775389, encodeId=bfdc1e75389d3, content=<a href='/topic/show?id=937d46650bf' target=_blank style='color:#2F92EE;'>#对照#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46650, encryptionId=937d46650bf, topicName=对照)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ae138776909, createdName=amyloid, createdTime=Tue Sep 11 01:50:00 CST 2018, time=2018-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588322, encodeId=fd161588322dc, content=<a href='/topic/show?id=1cb8e014e0' target=_blank style='color:#2F92EE;'>#ESI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7014, encryptionId=1cb8e014e0, topicName=ESI)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f4f817593223, createdName=skhzy, createdTime=Tue Mar 20 01:50:00 CST 2018, time=2018-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=297422, encodeId=d3f829e42237, content=对临床病人大有益处.多多推广, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK29w9r0upRgxUXHNhe7bd3VxHnhBSpibMbKOjtX92zXr78SkuZfUNuADrjHiaw6uibZaEYjh9cJLzew/132, createdBy=261e1682638, createdName=1de3b290m83(暂无匿称), createdTime=Sun Mar 18 14:34:15 CST 2018, time=2018-03-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=297400, encodeId=4cc929e4007e, content=学习了.不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Sun Mar 18 11:40:26 CST 2018, time=2018-03-18, status=1, ipAttribution=)]
    2018-03-18 1ddf0692m34(暂无匿称)

    学习了.不错

    0

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