Pediatric Anesthesia最新文献

{"title":"Effects of Esketamine on Emergence Delirium in Children Undergoing Sevoflurane Anesthesia: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis.","authors":"Munder Lateiresh, Abdelaziz Louat, Mukhtar Alwefati, Alhasan Altayf, Matthieu Legrand, Phillip D Cohen, Eman Abdulwahed, Sapna R Kudchadkar, Muhammed Elhadi","doi":"10.1002/pan.70272","DOIUrl":"10.1002/pan.70272","url":null,"abstract":"<p><strong>Background: </strong>Emergence delirium is a frequent and distressing postoperative complication in children, particularly following sevoflurane-based anesthesia. Despite its clinical importance, the optimal preventive strategy remains under investigation. This study aims to systematically evaluate the efficacy and safety of esketamine in preventing emergence delirium in pediatric patients undergoing sevoflurane-based general anesthesia.</p><p><strong>Methods: </strong>We systematically searched seven databases and registries through 27 March 2026. Randomized controlled trials that compared esketamine with placebo in children undergoing surgical procedures were included. The primary outcome was the incidence of emergence delirium. Secondary outcomes were postoperative pain scores, extubation time, post-anesthesia care unit stay, and postoperative nausea and vomiting. Data were synthesized using random-effects models, with risk ratios for dichotomous outcomes and mean differences or standardized mean differences for continuous outcomes. Meta-regression and trial sequential analysis were performed. The risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials, and the certainty of the evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation approach.</p><p><strong>Results: </strong>Eight randomized controlled trials involving 916 patients were included. Esketamine significantly reduced the incidence of emergence delirium versus placebo (risk ratio = 0.35; 95% confidence interval: 0.26-0.48; p < 0.0001). No significant differences were observed between dosing regimens, surgical types, routes of administration, or timing of administration. Pain scores were significantly lower with esketamine (standardized mean difference = -0.58; 95% confidence interval: -0.79 to -0.37; p < 0.0001). Extubation time was modestly prolonged (mean difference = 1.72 min; 95% confidence interval: 0.20-3.24; p = 0.0267). Meta-regression revealed a statistically significant association between emergence delirium risk ratios and anesthesia duration (β = 0.98, p = 0.042), with no other significant associations observed for the other covariates. Post-anesthesia care unit stay showed no statistically significant difference, while postoperative nausea and vomiting was significantly reduced with esketamine (risk ratio = 0.69; 95% confidence interval: 0.49-0.97; p = 0.0304). No study was at high-risk of bias; four studies raised some concerns. Certainty of evidence was moderate, except for extubation time, which was low.</p><p><strong>Conclusions: </strong>Esketamine demonstrates promising efficacy for preventing emergence delirium and improving postoperative pain in children.</p><p><strong>Prospero: </strong>CRD420251230407.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":"1361-1374"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EEG Artifacts During Pediatric Cardiopulmonary Bypass: Three Illustrative Cases.","authors":"Valeria Taurisano, Andrew Matisoff, Igor Luginbuehl","doi":"10.1002/pan.70311","DOIUrl":"10.1002/pan.70311","url":null,"abstract":"","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":"1467-1470"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Study of Socioeconomic Status and Emergence Delirium.","authors":"Tiffanie Lautenbach, Vinod Patil","doi":"10.1002/pan.70264","DOIUrl":"10.1002/pan.70264","url":null,"abstract":"","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":"1477-1478"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated Versus Manual Endotracheal Tube Cuff Pressure Control in Mechanically Ventilated Children: A Randomized Crossover Trial.","authors":"Ekin Soydan, Esat Erdem Gokpınar, Ozlem Karakaya, Zeynep Gökoglu Sevinc, Gokhan Ceylan, Mehmet Gurkan Erbas, Selma Albayrak, Özlem Demirel, Ece Dorsan Yay, Kaan Aslan, Nihal Karaöz Özdamar, Nuriye Turgut, Utku Karaarslan, Hasan Agin","doi":"10.1002/pan.70268","DOIUrl":"10.1002/pan.70268","url":null,"abstract":"<p><strong>Background: </strong>Optimal endotracheal tube cuff pressure is key for airway sealing and minimizing microaspiration and tracheal injury in ventilated children. However, intermittent manual monitoring can allow significant pressure changes and be affected by measurement artifacts, potentially reducing airway protection.</p><p><strong>Aims: </strong>This study evaluated whether automated cuff pressure control better maintains target pressure than manual monitoring in ventilated children, and assessed its effects on off-target pressure and workload.</p><p><strong>Methods: </strong>In this prospective, randomized crossover study, mechanically ventilated pediatric patients (1 month-18 years) expected to require ventilation for ≥ 48 h underwent two randomized 24-h monitoring phases (manual and automated). During the manual phase, cuff pressure was continuously displayed via a closed system without repeated disconnection of the manometer and was intermittently adjusted by bedside nurses according to a predefined protocol. During the automated phase, cuff pressure was continuously regulated using an automated control system to maintain a target range of 15-25 cmH₂O. The primary outcomes were the frequency and cumulative duration of off-target cuff pressure exposure; secondary outcomes included nursing workload.</p><p><strong>Results: </strong>Thirty-two patients completed both phases (768 measurements). Low cuff pressure episodes (< 15 cmH₂O) were more frequent during manual monitoring than automated monitoring (12.7% vs. 1.3%, p < 0.001), while high-pressure episodes (> 25 cmH₂O) occurred only during manual monitoring (2.6% vs. 0%, p < 0.001). Total time outside the target range was markedly reduced with automated monitoring (118 vs. 10 h, p < 0.001). Nursing workload was significantly lower in the automated phase (3.65 h vs. 0.08 h, p < 0.001).</p><p><strong>Conclusions: </strong>Automated cuff pressure control more reliably maintains target pressure and minimizes clinically important deviations compared to manual management. These results support adopting continuous automated regulation as a preferred strategy to enhance airway safety and reduce workload in mechanically ventilated children.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (NCT06965400).</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":"1400-1408"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148472001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives in Pediatric Ambulatory Anesthesia: Part 3-One Center's Evolving Regional Anesthesia Experience and Outcomes.","authors":"David E Liston, Elizabeth E Hansen, Jennifer L Chiem, Sean H Flack, Daniel K W Low, Lynn D Martin","doi":"10.1002/pan.70255","DOIUrl":"10.1002/pan.70255","url":null,"abstract":"<p><strong>Introduction: </strong>Pediatric ambulatory surgery is the dominant model of surgical care in the U.S. and has impacted the practice of regional anesthesia (RA). Pediatric RA's use has expanded as a supplement to general anesthesia with the introduction of ultrasound. We wish to document RA practice changes over the last 14 years in our ambulatory surgery center (ASC).</p><p><strong>Methods: </strong>A retrospective review of RA practice from 7/2010 to 12/2024 at a free-standing pediatric ASC was performed. A commercial software system extracted de-identified, aggregated health data from the system's EMR. Using statistical process control methods, data were processed to distinguish between common and special cause variation.</p><p><strong>Results: </strong>Incidence of peripheral nerve blocks (PNB) was 13% and increased to 35.4% (associated with ultrasound use and pudendal block standard for penile surgery). The inverse was seen with central neuraxial block (CNB), dropping from 10% of cases to 2%. At baseline 25% of cases received a single injection block, increasing three-fold (associated with ultrasound/pudendal introductions, COVID-related reduction in non-regional cases, and non-regional case volume recovery). The incidence of continuous catheter cases was 3.7% and decreased twice (associated with COVID and sports medicine catheter program closure). Anesthesia preparation time with RA decreased from 16.8 to 12.5 min (associated with ultrasound introduction, end of COVID restrictions, and sports medicine catheter program closure). The first attempt RA success rate was high (PNB-90%, CNB-83%; single injection-89%, continuous catheter-96%). PACU maximum pain and opioid use rates decreased for RA and non-RA patients. Wrong-site blocks, their root cause analyses, and improvements to the RA timeout are discussed.</p><p><strong>Discussion: </strong>This review's key findings include an evolution in RA practice, which in conjunction with opioid-sparing efforts, have driven improvements in clinical outcomes. Our ambulatory pediatric RA practice may not reflect practice seen in others; thus, we do not make inferences outside our facility.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":"1341-1351"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Use, Monitoring and Reversal of Neuromuscular Block in Pediatric Anesthesia and Intensive Care: A Web-Based Cross-Sectional ESAIC Survey.","authors":"Giulia Bonatti, Mirjana Gander, Arash Afshari, Francis Veyckemans, Thomas Fuchs-Buder, Thomas Riva, Markus Huber, Nicola Disma, Alexander Fuchs","doi":"10.1002/pan.70285","DOIUrl":"10.1002/pan.70285","url":null,"abstract":"<p><strong>Background: </strong>Neuromuscular blocking agents are recommended by the European Society of Anaesthesiology and Intensive Care (ESAIC) and European Society of Paediatric Anaesthesia (ESPA) for facilitating tracheal intubation in children. Despite these recommendations, real-world data on how neuromuscular blocking agents are used, monitored, and reversed remain scarce.</p><p><strong>Aims: </strong>To identify and characterize self-reported neuromuscular blocking agent practice patterns across European and non-European countries, in the period preceding publication of the joint ESAIC and ESPA guidelines.</p><p><strong>Methods: </strong>We conducted an anonymous, cross-sectional survey between 12 November and 12 December 2025, targeting members of the ESAIC, ESPA, and the French and Spanish national pediatric anesthesiology societies involved in pediatric airway management across 43 countries.</p><p><strong>Results: </strong>The survey was accessed by 904 persons, and 874 responses were included in the analysis. Most participants were from Europe (83.5%) and worked in mixed pediatric anesthesia and intensive care settings (71.2%). Rocuronium was the most frequently used neuromuscular blocking agent for both routine tracheal intubation (68%; 95% CI 65%-71%) and rapid sequence intubation (67%; 95% CI 64%-70%). Neuromuscular blocking agents were used \"always\" or \"mostly\" before routine intubation in 47% of neonates (≤ 30 days) and 50% of infants (< 1 year), whereas \"rarely\" or \"never\" use was reported in 30% and 24%, respectively. Most respondents (56%) assessed adequacy of neuromuscular block using a fixed time interval after neuromuscular blocking agent administration. Reversal was administered \"always\" before extubation by 27% of respondents, while 9.3% reported \"rarely\" and 2.9% \"never.\" Only half of participants used quantitative neuromuscular monitoring to guide reversal. Sugammadex was used by 47%.</p><p><strong>Conclusions: </strong>Self-reported clinical practice regarding neuromuscular blocking agent use in pediatric patients remains heterogeneous. Children are frequently intubated without neuromuscular blocking agents and extubated without consistent reversal. Quantitative neuromuscular monitoring remains uncommon. These practice patterns raise concerns for patient safety.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":"1437-1448"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Ultra-low-dose Ketamine for Reducing Pain Intensity and Total Opioid Requirement in Children With Opioid-Refractory Pain.","authors":"Jennifer A Busse, Daniel S Tsze, Justin Genziano, Thomas Bachmann, Jenna Forrester, Keely Craig, William S Schechter","doi":"10.1002/pan.70276","DOIUrl":"10.1002/pan.70276","url":null,"abstract":"","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":"1427-1428"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recognizing Strokes in the Post-Anesthesia Care Unit in Adult Versus Pediatric Patients.","authors":"Juliet Velhagen, Thomas Ferrer, Sagar Patel, Ricardo Falcon, Marius Birlea, Timothy R Petersen, Davit Kocharyan, Codruta Soneru","doi":"10.1002/pan.70280","DOIUrl":"10.1002/pan.70280","url":null,"abstract":"<p><strong>Background: </strong>Postoperative strokes can occur in adult and pediatric patients, with both ischemic and hemorrhagic etiologies. Unfortunately, it can be difficult to distinguish stroke symptoms from lingering anesthetic-related neurological effects. Even though there is currently no standardized screening tool, a systematic approach to symptomatic differentiation between anesthetic effects and stroke symptoms can help ensure early diagnosis of a stroke and thus minimize both morbidity and mortality.</p><p><strong>Aims: </strong>This review aims to provide an overview of perioperative stroke in pediatric and adult patients, including epidemiology, clinical presentation, and risk factors, as well as an approach to differentiating suspected stroke from anesthetic-related neurological effects in the post-anesthesia care unit (PACU).</p><p><strong>Discussion: </strong>In addition to symptomatology, stroke recognition in the PACU may be facilitated by incorporating consideration of the many perioperative stroke risk factors including surgery type, medications, and both modifiable and non-modifiable patient risk factors. While PACU strokes are rare, any delay in diagnosis and thus treatment can exacerbate adverse outcomes, so it remains important to maintain suspicion of stroke in patients with concerning symptoms and risk factors.</p><p><strong>Conclusions: </strong>This focused review discusses stroke etiology, its varying risk factors and symptomatology in pediatric and adult patients, and appropriate steps to take when confronted with concerning neurological symptoms in the PACU.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":"1352-1360"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Study on Time Impact of Major Trauma Patients Requiring Access to the Operating Room on the Anesthesia Department of a Pediatric Trauma Center.","authors":"Ruth Bird, Martina Bordini, Suzanne Beno, Clyde T Matava","doi":"10.1002/pan.70278","DOIUrl":"10.1002/pan.70278","url":null,"abstract":"<p><strong>Background: </strong>Trauma is one of the leading causes of death in children. Trauma patients have been demonstrated to require significant resources, including operating room time. We aimed to describe the characteristics and patterns of access to surgery and outcomes of pediatric major trauma patients at The Hospital for Sick Children.</p><p><strong>Methods: </strong>We retrospectively collected data from the Hospital for Sick Children trauma registry and the hospital's patient electronic record, from June 01, 2018, to October 31 2020. We analyzed a subset of patients requiring surgery in the operating room. The objective was to describe the distribution of major trauma cases requiring operating room access and their hospital length of stay, blood product use, and mortality rates. We summarized the results into three groups based on operating room access timing: patients with immediate access, within 24 h, and after 24 h.</p><p><strong>Results: </strong>In total, 141 of 721 pediatric major trauma patients (19.6%) underwent surgery and were included. Among these, 67 patients received immediate access to the operating room (47.5%), 37 patients received access within 24 h (26.2%) and 37 patients received access after 24 h (26.2%). The median age was 8 (0-17) years, and 65.2% of patients were male. The median ISS score was 11.5 (1-57). The most frequently involved surgical specialties were orthopedics and neurosurgery. The median hospital length of stay was 6 days (range 1-102). The mortality rate was 1.4%. A multivariable regression analysis showed a correlation between the number of surgical procedures and length of stay (p < 0.01, 95% confidence interval 9.11-11.64).</p><p><strong>Conclusion: </strong>Major trauma patients have a significant time impact on the anesthesia department. Further studies are needed to better define the pediatric trauma population and its intra-hospital flow and resource use.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":"1417-1426"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Postoperative Acute Kidney Injury After Noncardiac Surgery: A Systematic Review and Meta-Analysis.","authors":"Arash Emami, Ebba Sivertsson, Johan Westerbergh, Michael Marks-Hultström, Johan Danielsson, Peter Frykholm, Robert Frithiof","doi":"10.1002/pan.70284","DOIUrl":"10.1002/pan.70284","url":null,"abstract":"<p><strong>Background: </strong>Postoperative acute kidney injury (AKI) is associated with substantial morbidity and mortality. Reliable estimates of AKI after surgery in children are lacking. To address this gap, we aimed to synthesize the available evidence on the incidence of AKI after pediatric noncardiac surgery.</p><p><strong>Methods: </strong>We searched PubMed, Cochrane and Web of Science for studies reporting the incidence of AKI, defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria, within 7 postoperative days. Observational studies and clinical trials including patients aged < 18 years were eligible. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.</p><p><strong>Results: </strong>Twenty-seven studies (n = 21 908) were included. Considerable heterogeneity (I² = 98.7%) and likely overrepresentation of clinically distinct high-risk populations limited the interpretability of a single overall pooled incidence estimate. The incidence was 22.3% (95% CI, 11.2-39.3) after neonatal surgery, 30.1% (95% CI, 21.4-40.6) after pediatric liver transplantation, and 9.2% (95% CI, 3.3-23.6) in mixed pediatric surgical populations. The certainty of evidence was rated low to very low. In mixed pediatric surgical populations, AKI incidence increased from 2.4% in American Society of Anesthesiologists (ASA) class 1-2 to 7.5% in ASA 3 (p < 0.001) and 18.9% in ASA 4-5 (p < 0.001), and decreased from 9.8% at 0-2 years to 4.0% at 12-18 years (p < 0.001).</p><p><strong>Conclusion: </strong>The reported incidence of postoperative AKI in children undergoing noncardiac surgery remains uncertain due to substantial heterogeneity and overrepresentation of high-risk populations. AKI incidence was high in neonates and liver transplant recipients and was associated with younger age and higher ASA class, although data were limited. Further prospective studies in broader pediatric surgical populations are needed to better assess the risk of postoperative AKI in children.</p><p><strong>Trial registration: </strong>PROSPERO registration no.: CRD42024518832.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":"1387-1399"},"PeriodicalIF":1.6,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}