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首页> 外文期刊>Journal of clinical anesthesia >Induction techniques for pediatric patients with congenital heart disease undergoing noncardiac procedures are influenced by cardiac functional status and residual lesion burden
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Induction techniques for pediatric patients with congenital heart disease undergoing noncardiac procedures are influenced by cardiac functional status and residual lesion burden

机译：具有心脏功能状态和残留病变负担的心功能性地位和残留病变负担的对心脏病患者的儿科患者的感应技术

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Study objectiveAppropriate agent selection in patients with congenital heart disease (CHD) undergoing cardiac surgery and catheterization have been extensively reviewed in the literature. To date, there has not been an analysis of induction drug choices made in a large group of CHD patients undergoing non-cardiac procedures and intraoperative events.The primary objective was to characterize induction agent selection in CHD patients undergoing non-cardiac procedures and examine its association with intraoperative events. DesignRetrospective chart review analysis. SettingA single center study. PatientsChildren with CHD who underwent non-cardiac procedures. Intervention/measurementUsing the electronic preoperative anesthesia evaluation form we identified 2966 cases performed under general anesthesia. We examined the association between patient characteristics (ASA PS and CHD severity) and induction drugs using multinominal logistic regression test. We also examined the association of induction drugs with intraoperative adverse events using Fisher exact test. Main resultsInhalational and intravenous inductions were conducted in 35.7% and 64.3% of general anesthesia cases, respectively. Sevoflurane was the main inhalation induction drug. Propofol was used as the induction agent in 54.3% of cases, while etomidate, midazolam/fentanyl, and ketamine were used as the induction agent in 18.3% 16.6%, and 10.1% of cases, respectively. ASA PS and CHD severity predicted induction drugs better than single ventricle status or ventricular function. Intraoperative inotrope use was seen more frequently in cases induced by ketamine, etomidate or opioids over sevoflurane or propofol. ConclusionsPatients with higher ASA classes and CHD of more severity tend to be induced more with etomidate, ketamine or opioids over sevoflurane or propofol. Use of etomidate, ketamine or opioids was more associated with inotrope use, but there was not significant difference in respiratory events among different induction agents. Causative association needs to be examined in the future.
机译：研究了在文献中进行了先天性心脏病（CHD）的患者患者的特工选择，并在文献中进行了广泛的审查。迄今为止，迄今未分析在经历非心脏手术和术中发生的大群CHD患者中制备的感应药物选择。主要目的是在经历非心脏手术后的CHD患者中表征诱导剂选择并检查其与术中事件相关联。 DesignRetrospiety图表评估分析。 Settinga单中心学习。患者与CHD接受非心脏手术的CHD。干预/测量电子术前麻醉评价表明，我们确定了在全身麻醉下进行的2966例。我们检查了使用多肢体物流回归测试的患者特征（ASA PS和CHD严重程度）和诱导药物之间的关联。我们还使用Fisher精确测试检查了诱导药物与术中不良事件的关联。主要的结果和静脉注射诱导分别以35.7％和64.3％的全身麻醉病例进行。七氟醚是主要吸入诱导药物。在54.3％的病例中使用异丙酚，而替代亚唑胺/芬太尼和氯胺酮分别以18.3％的16.6％和10.1％的病例用作诱导剂。 ASA PS和CHD严重程度预测诱导药物优于单个心室状态或心室功能。在甲胺酮，戊胺或阿片类甲磺酰胺或异丙酚上诱导的病例中更频繁地看到术中的肌室使用。结论具有更高的ASA类和更严重程度的CHD的障碍倾向于在七氟醚或异丙酚上用戊胺，氯胺酮或阿片类药物诱导更多。使用戊胺，氯胺酮或阿片类药物与Ocotrope使用更有关，但不同诱导剂之间的呼吸事件差异没有显着差异。需要在将来审查致命关联。

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