A retrospective analysis of the duration of mechanical ventilation in Scandinavian paediatric heart centres.

A retrospective analysis of the duration of mechanical ventilation in Scandinavian paediatric heart centres.
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DOI:
10.1111/apa.16244
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发表时间:
2022-04
期刊:
影响因子:
3.8
通讯作者:
Rautiainen, Paula
Rautiainen, Paula
中科院分区:
医学4区
文献类型:
--
作者:
Koski, Tapio;Salmi, Heli;Keski-Nisula, Juho;Bille, Anders;Bjornsson, Einar;Jessen, Casper;Forstholm, Ronnie;Laaperi, Mitja;Rautiainen, Paula

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心脏手术后早期拔管可缩短儿科重症监护病房(PICU)的住院时间(LOS),减少机械通气(MV)的并发症。我们探讨了斯堪的纳维亚儿科心脏中心的MV持续时间。我们回顾了2015-2016年间在斯堪的纳维亚四个中心为房间隔缺损(ASD)、室间隔缺损(VSD)、法洛四联症(TOF)或全腔静脉肺动脉连接术(TCPC)手术的696名儿童的MV持续时间和PICU LOS。新生儿(n=990)包括在内,与心脏手术类型无关。ASD患者的拔管时间中位数为3.25h(四分位数范围2.00-4.83),其次是TCPC(中位数5.00 h,IQR 2.60-16.83)、室间隔缺损(中位数7.00 h,IQR 3.69-22.25)和TOF(中位数18.08h,IQR 6.00-41.38)。新生儿未提前拔管(中位数94.42h,IQR45.03~138.14)。虽然机械通气持续时间反映在PICU LOS中,但在12小时内拔管的患者中这一点并不明显。瑞典中心的机械通气持续时间和PICU LOS最短。拔管失败24/696例(3.4%)。斯堪的纳维亚的儿科心脏中心在术后MV持续时间上有所不同。将拔管时间推迟至术后12h并未明显延长PICU LOS。
Early extubation after cardiac surgery shortens paediatric intensive care unit (PICU) length of stay (LOS) and decreases complications from mechanical ventilation (MV). We explored the duration of MV in Scandinavian paediatric heart centres. We retrospectively reviewed the MV duration and PICU LOS of 696 children operated for atrial septal defect (ASD), ventricular septal defect (VSD), tetralogy of Fallot (TOF) or total cavopulmonary connection (TCPC) in four Scandinavian centres in 2015–2016. Neonates (n = 90) were included regardless of heart surgery type. Patients with ASD were extubated at a median of 3.25 h (interquartile range [IQR] 2.00–4.83), followed by patients with TCPC (median 5.00 h, IQR 2.60–16.83), VSD (median 7.00 h, IQR 3.69–22.25) and TOF (median 18.08 h, IQR 6.00–41.38). Neonates were not extubated early (median 94.42 h, IQR 45.03–138.14). Although MV durations were reflected in PICU LOS, this was not as apparent among those extubated within 12 h. The Swedish centres had shortest MV durations and PICU LOS. Extubation failed in 24/696 (3.4%) of patients. Scandinavian paediatric heart centres differed in the duration of postoperative MV. Deferring extubation up to 12 h postoperatively did not markedly prolong PICU LOS.
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