Ventilatory weaning strategies for predicting extubation success in children following cardiac surgery for congenital heart disease: a protocol for a systematic review and meta-analysis.
Ventilatory weaning strategies for predicting extubation success in children following cardiac surgery for congenital heart disease: a protocol for a systematic review and meta-analysis.
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DOI：
10.1136/bmjopen-2021-054128
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发表时间：
2022-04-29
期刊：
影响因子：
2.9
通讯作者：
Nakano, Luis Carlos Uta
中科院分区：
文献类型：
--
作者：
Garcia, Amanda Alves Assis;Vieira, Alexia Gabriela da Silva;Kuramoto, Danielle Akemi Bergara;Leite, Ilana Gomes;de Freitas, Thais Rodrigues;Reicher, Marcello Erich;Trevisani, Virginia Fernandes Moca;Guedes Neto, Henrique Jorge;Flumignan, Ronald Luiz Gomes;de Amorim, Jorge Eduardo;Nakano, Luis Carlos Uta
先天性心脏病(CHD)包括危害心脏结构和功能的解剖畸形。它可能非常复杂和严重，相当于生命第一个月所有死亡人数的30%。手术入路需要术后机械通气才能得到充分的治疗。对于心脏手术患者的术后管理，最关键的决定是拔管的正确时机，特别是因为突然或不适当地停止机械支持不仅会导致临床病情下降和重新插管的必要性，而且还会延长机械通气的时间，这可能会导致肺炎、肺不张、横隔膜肥大等并发症，并增加发病率和死亡率。这项系统性审查计划包括与任何呼吸试验测试有关的个人平行、交叉和分组随机对照试验，以预测因冠心病而接受心脏手术的儿童的拔管成功。对因先天性心脏病接受心脏手术、在重症监护病房接受治疗并在机械通气支持下接受治疗的儿科患者进行的研究将包括在内。分析的主要结果是拔管成功，减少肺部并发症，缩短机械通气时间。我们不会直接治疗患者；因此，伦理委员会的批准是不必要的，因为这不是一项主要研究。我们希望这项研究可以改善医疗保健和医疗辅助，帮助医疗保健专业人员就正确的拔管时间做出日常决定。CRD42021223999。
Congenital heart disease (CHD) comprises the anatomic malformations that jeopardise the structure and function of the heart. It can be extremely complex and serious, corresponding to 30% of all deaths in the first month of life. The surgical approach for adequate treatment requires postoperative mechanical ventilation. The most critical decision related to the postoperative management of patients submitted to cardiac surgery is the right time for extubation, especially because not only abrupt or inadequate discontinuation of ventilatory support can lead to clinical decline and necessity of reintubation but also extended time of mechanical ventilation, which can lead to complications, such as pneumonia, atelectasis, diaphragm hypertrophy, and increasing morbidity and mortality. This systematic review plans to include individual parallel, cross-over and cluster randomised controlled trials regarding any breathing trial test to predict extubation success in children submitted to cardiac surgery due to CHD. Studies with paediatric patients submitted to cardiac surgery for congenital cardiopathy repair, attended at a critical care unit, and under mechanical ventilatory support will be included. The main outcomes analysed will be success of extubation, reduction of pulmonary complications and time reduction of mechanical ventilation. We will not treat patients directly; therefore, ethics committee approval was not necessary because it is not a primary study. We expect that this study may improve healthcare and medical assistance, helping healthcare professionals with routine daily decisions regarding the correct time for extubation. CRD42021223999.
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影响因子：
4.1
作者：
Ferreira, Felipe V.;Sugo, Edward K.;Carlotti, Ana P. C. P.
通讯作者：
Carlotti, Ana P. C. P.
影响因子：
38.9
作者：
Farias, JA;Retta, A;Moreno, EG
通讯作者：
Moreno, EG
影响因子：
4.6
作者：
BARASH, PG;LESCOVICH, F;STANSEL, HC
通讯作者：
STANSEL, HC
影响因子：
3.7
作者：
Ouzzani M;Hammady H;Fedorowicz Z;Elmagarmid A
通讯作者：
Elmagarmid A
DOI：
10.1590/s0102-76382008000400008
发表时间：
2008-12-01
影响因子：
1.3
作者：
Silva, Zuleica Menezes;Perez, Angela;Rovedder, Paula Maria Eidt
通讯作者：
Rovedder, Paula Maria Eidt