Finding the contribution of the autonomic nervous system during perioperative events in children with Down Syndrome

寻找唐氏综合症儿童围手术期事件中自主神经系统的贡献

基本信息

批准号：
10295867
负责人：
Jamie W Sinton
金额：
$ 42.11万
依托单位：
CINCINNATI CHILDRENS HOSP MED CTR
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-17 至 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10295867
关键词：
8 year old Acute Pain Address Adolescent Adult Age Ambulatory Monitoring Anesthesia procedures Anesthetics Anxiety Autonomic Dysfunction Autonomic nervous system Behavior Biology Bradycardia Cardiac Output Characteristics Child Childhood Clinical Dangerousness Data Development Down Syndrome Eligibility Determination Equilibrium Etiology Event Exposure to Feasibility Studies Frequencies Future General Anesthesia Goals Heart Abnormalities Heart Rate Home Individual Infant Inhalation Intervention Knowledge Lead Medical Monitor Nature Nervous system structure Operative Surgical Procedures Outcome Patients Perioperative Physiological Physiology Plant Roots Population Postoperative Pain Procedures Protocols documentation Randomized Controlled Clinical Trials Recovery Research Design Risk Role Sample Size Stress Techniques Testing Time TimeLine Toddler base congenital anomaly experience feasibility testing hemodynamics improved insight non-invasive monitor patient population peer perioperative morbidity sevoflurane

项目摘要

PROJECT SUMMARY/ABSTRACT Children with Down syndrome (DS) often experience dangerously low heart rates on induction of anesthesia for routine procedures and this occurs at 10 times the rate of non-DS patients. Given that the cardiac output of children is heart rate dependent, bradycardia is especially perilous in this population. Historically, individuals with DS were not expected to survive beyond childhood; consequently, correction of congenital anomalies, e.g. cardiac defects, was not frequently offered. Fortunately, today individuals with DS live into adulthood and surgical correction of anomalies is universally offered. Thus, increasing numbers of children with DS are exposed to anesthesia and at risk for this hemodynamic catastrophe. It is medically unacceptable and requires more study. This project seeks to address the problem of induction bradycardia by studying its mechanism. We plan to quantify nervous system determinants of heart rate during these bradycardic events and eventually develop protocols to identify and mitigate the risk. Specifically, we aim to: 1) Quantify the autonomic nervous system behavior during induction using multi-parameter monitoring to potentially unveil their root cause. 2) Test the feasibility of that autonomic nervous system monitor using both ambulatory and perioperative monitoring protocols to detect which patients are at risk. Successful completion of this project will provide the physiologic information required to reduce the risk of morbid bradycardic events on induction of anesthesia in children with DS.

项目摘要/摘要唐氏综合症（DS）的儿童经常在诱发麻醉时经历危险的低心率对于常规程序，这发生在非DS患者率的10倍。鉴于心脏输出的儿童是心率依赖性的，在这个人群中心动过缓尤其危险。从历史上看，患有DS的人不会超越儿童时期。因此，校正先天异常，例如心脏缺陷不经常提供。幸运的是，今天有DS的人普遍提供了成年和对异常的手术校正。因此，越来越多的人数患有DS的儿童暴露于麻醉，有这种血液动力学灾难的风险。它是医学上的不可接受，需要更多的研究。该项目旨在通过研究其机制来解决诱导性心动过缓的问题。我们计划量化这些心动过心事件中心率的神经系统决定因素，并最终发展识别和减轻风险的协议。具体来说，我们的目标是： 1）使用多参数监测到诱导过程中的自主神经系统行为潜在地揭示其根本原因。 2）使用卧床和围手术期测试该自主神经系统监测器的可行性监视方案以检测哪些患者有危险。该项目的成功完成将提供降低的生理信息 DS儿童麻醉诱导的病态心动过缓事件。