超声引导下桡动脉插管在<24月龄儿科外科患者中的应用

IF 0.2 Q4 ANESTHESIOLOGY
A. Simalti, Badal Parikh, VK Shankhyan, Saajan Joshi
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引用次数: 0

摘要

背景:在复杂的儿科手术和先天性心脏异常患者的围手术期管理中,动脉插管越来越成为护理的标准。这些留置动脉插管用于有创血压(IBP)监测和血气分析。随着超声时代的到来,人们对其在儿科动脉插管中的应用越来越感兴趣。然而,就成功率和并发症而言,关于其益处的文献有限。目的:本研究的目的是评估在儿科手术患者中使用超声引导进行动脉插管的成功率和并发症。设置和设计:三级护理中心手术室/前瞻性观察研究。统计学:描述性统计。材料和方法:这项研究是在24个月以下的儿童中进行的,他们在手术期间需要监测IBP。观察到的参数包括插管成功率,细分为第一次尝试成功率、前两次尝试内成功插管、插管成功时间和插管数量。并发症,即血肿和缺血性损伤也有记录。结果:本研究共纳入258名儿童。我们在95.74%的患者中成功地进行了桡动脉插管,其中77.9%是第一次尝试,8.1%需要两次尝试。所花费的中位时间约为168秒。在33例(13%)病例中,穿刺前根据血栓或动脉直径非常窄而改变了位置。21名(8.1%)儿童出现血肿形成,只有2名(0.7%)儿童远端缺血,需要从桡动脉中取出套管。结论:本研究强调了常规使用超声的好处,即在24个月以下的儿童患者中,首次尝试成功的几率更高,插管时间更短,所需时间更短,以及超声引导的桡动脉插管更客观的训练益处。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ultrasound-guided radial artery cannulation in pediatric surgical patients <24 months of age
Background: Arterial cannulation is increasingly becoming the standard of care in the perioperative management of complex pediatric surgeries and in patients with congenital cardiac anomalies. These indwelling arterial cannulas are used for invasive blood pressure (IBP) monitoring and blood gas analysis. With advent of ultrasound era, there is rising interest for its application in pediatric arterial cannulation. However, limited literature is available on its benefit in terms of success rate and complications. Aims: The aim of this study is to assess the success rate and complications when ultrasound guidance was used for arterial line insertion in the pediatric surgical patients. Setting and Design: Operation Theatre of Tertiary Care Centre / Prospective Observational Study. Statistics: Descriptive statistics. Materials and Methods: This study was conducted in children aged below 24 months requiring IBP monitoring during surgery. Parameters observed included rate of successful cannulation subdivided into first attempt success rate, successful cannulation within first two attempts, time to successful cannulation, and number of cannula. Complications namely hematoma and ischemic damage were also documented. Results: A total of 258 children were included in this study. We achieved successful radial artery cannulation in 95.74% patients, of which 77.9% were in first attempt while 8.1% required two attempts. The median time taken was about 168 s. In 33 (13%) cases, the site was changed before pricking based on thrombus or very narrow diameter of the artery. Hematoma formation was seen in 21 (8.1%) children, and only 2 (0.7%) children had features of ischemia in the distal part requiring removal of the cannula from radial artery. Conclusions: This study emphasized benefits of routine use of ultrasound in terms of higher chances of first-attempt success, lesser time for cannulation, lesser time taken, and more objective training benefit from ultrasound-guided radial artery cannulation in pediatric patients less than 24 months of age.
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来源期刊
Indian Anaesthetists Forum
Indian Anaesthetists Forum ANESTHESIOLOGY-
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17
审稿时长
6 weeks
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