SEDATION OF PEDIATRIC BRONCHOSCOPY

工作总结：本研究的目的是回顾镇静作用 在我们的重症监护室（ICU）中使用的儿科组合 支气管镜检查。64例年龄1至18岁的患者， 从ICU数据库中识别为接受了光纤 支气管镜检查伴支气管肺泡灌洗或经支气管活检 从1991年6月到1995年12月。回顾性病历审查是 在这些病人身上。用于治疗的药物剂量 记录镇静并计算mg/kg剂量。还注意到， 手术持续时间和并发症，包括氧饱和度下降， 心动过缓和神经心理并发症共有103 对64例患者进行了支气管镜检查。氯胺酮和咪达唑仑 在42例手术中使用了芬太尼和咪达唑仑， 38.其余23例手术使用了其他药物组合。七十 氯胺酮组的%在术前接受阿托品作为 抗氧化剂13例患者出现严重并发症，包括 氧饱和度下降喘鸣咳嗽和鼻出血十二人 氯胺酮治疗患者发生13例并发症， 与另一个代理商的组合。13例并发症中有12例发生在 艾滋病患者。13例并发症中有8例 3岁或以下儿童。氯胺酮是一种有用的药物， 在儿科手术中使用镇痛剂多年。然而，儿科 支气管镜检查，由于其对小儿气道的侵入性， 它对已经受损的肺的影响，可能是一个例外， 氯胺酮的安全性它的使用，特别是在较小的气道， 可能需要重新考虑，并应进行前瞻性评估。一 手稿已提交给Chest。

Summary of Work: The objective of this study is to review the sedation combinations used in our intensive care unit (ICU) for pediatric bronchoscopic procedures. Sixty-four patients age 1 to 18 years were identified from the ICU database as having undergone fiberoptic bronchoscopy with bronchoalveolar lavage or transbronchial biopsy between June 1991 and December 1995. A retrospective chart review was performed on those patients. The dosages of medications used for sedation were noted and a mg/kg dose was calculated. Also noted were the procedure duration and complications including oxygen desaturation, bradycardia, and neuropsychologic complications. A total of 103 bronchoscopies were performed in 64 patients. Ketamine and midazolam were used in 42 procedures, while fentanyl and midazolam were used in 38. The remaining 23 procedures used other drug combinations. Seventy percent of the ketamine group received atropine pre-procedure as an anti-sialogue. Major complications were found in 13 patients, including oxygen desaturation, stridor, cough, and nasal bleeding. Twelve of the 13 complications occurred in patients treated with ketamine in combination with another agent. Twelve of the 13 complications were in patients with HIV disease. Eight of the 13 complications involved children 3 years old or younger. Ketamine has been a useful drug for analgesia in pediatric procedures for many years. However, pediatric bronchoscopy, by virtue of its invasiveness of the pediatric airway and its impact on an already compromised lung, may be an exception to the safety profile of ketamine. Its use, especially in the smaller airway, may need to be reconsidered and should be evaluated prospectively. A manuscript has been submitted to Chest.