单心室心脏手术后护理期间儿童肺泡功能分数与临床结果之间的关系。

IF 0.9 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Annals of Pediatric Cardiology Pub Date : 2023-11-01 Epub Date: 2024-04-23 DOI:10.4103/apc.apc_111_23
Dana Barry, Ellen A Spurrier, Jigar C Chauhan
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引用次数: 0

摘要

背景:优化肺血流与全身血流(Qp:Qs)是单心室儿童术后护理的关键。被称为肺泡功能分数(AFF)的潮气末二氧化碳与二氧化碳分压的比值与 Qp.Qs 的关系密切:Qs 的关系密切(Qp:Qs 为 1 时,AFF 为 0.7)。由于没有研究了解 AFF 与这些儿童术后护理的临床结果之间的关系,因此开展了这项研究:这项回顾性队列研究包括 29 名接受单心室心脏手术的儿童的术后情况。计算了每个术后早期的平均 AFF。主要临床结果是乳酸恢复正常的时间(小时)。其他临床结果包括机械通气持续时间、米力农输注持续时间;是否出现急性肾损伤(AKI)、癫痫发作和坏死性小肠结肠炎(NEC);是否需要气管造口术、是否需要体外支持以及术后前60天的死亡率。研究对象分为 AFF ≤0.7 的第一组和 AFF >0.7 的第二组,以比较两组之间的结果差异。乳酸正常化时间与 AFF 呈轻度负相关,整个组群的 Pearson's r = -0.49 (P = 0.007)。AFF≤0.7组和AFF>0.7组的临床结果无统计学差异,但AFF≤0.7组的NEC发生率和死亡率较高,而AFF>0.7组的AKI发生率较高:在这项小型研究中,AFF与单心室心脏手术后护理中乳酸恢复正常的时间呈适度负相关。与其他一些重要的临床结果也有相关趋势,但没有统计学意义。需要进行更大规模的多中心研究来进一步确定这些关系。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Relationship between alveolar functional fraction and clinical outcomes in children during postoperative care after surgery for single-ventricular heart.

Background: Optimization of pulmonary to systemic blood flow (Qp: Qs) is the key to postoperative care of children with a single-ventricular heart. The ratio of end-tidal CO2 to partial pressure of CO2 called alveolar functional fraction (AFF) has shown a strong relationship with Qp: Qs in the catheterization lab in this population (with Qp: Qs of 1 correlating with AFF of 0.7). As there are no studies to understand the relationship between AFF and clinical outcomes in the postoperative care of these children, this study was carried out.

Methodology and results: This retrospective cohort study included 29 postoperative periods of children who underwent surgery for a single-ventricular heart. The average AFF was calculated for each early postoperative period. The primary clinical outcome was time in hours to normalize lactate. Other clinical outcomes included duration of mechanical ventilation, duration of milrinone infusion; presence of acute kidney injury (AKI), seizures and necrotizing enterocolitis (NEC); need for tracheostomy, need for extra-corporeal support, and mortality in the first 60 days postoperatively. The study population was divided into Group 1 with AFF ≤0.7 and Group 2 with AFF >0.7, to compare the outcome differences between the groups. Time to normalize the lactate had a modest negative correlation with the AFF, with Pearson's r = -0.49 (P = 0.007) for the entire cohort. The clinical outcomes were not statistically different for groups with AFF ≤0.7 and with AFF >0.7, although the group with AFF ≤0.7 had a higher incidence of NEC and higher mortality, whereas the group with AFF >0.7 had a higher incidence of AKI.

Conclusions: In this small study, the AFF showed a modest negative correlation with the time to normalize lactate in postoperative care after surgery for a single-ventricle heart. There were the trends with some other important clinical outcomes but not statistically significant. A larger, multi-center study is needed to delineate these relationships further.

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来源期刊
Annals of Pediatric Cardiology
Annals of Pediatric Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
1.40
自引率
14.30%
发文量
51
审稿时长
23 weeks
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