目的:本研究的目的是评估闭环采样方法对心脏手术后儿科患者失血和输血需求的影响。
方法:回顾性观察研究。
方法:单一三级中心。
方法:纳入所有在心脏手术后入住儿科重症监护病房(PICU)的小于4岁的儿科患者。该研究包括保守组(术后)中的100名儿科患者和非保守组(实施前)中的43名儿科患者。
方法:观察性。
方法:主要结果是PICU随访期间的失血量。次要结果是每组的输血需求,机械通气的持续时间,重症监护病房(ICU)住院时间,住院时间,和死亡率。
结果:在保守(充血后)组中,随访期间失血量为0.67(0.33-1.16)mL/kg/d,而非保守(实施前)组为0.95(0.50-2.30)mL/kg/d,证实保守组的失血量显著减少(p=0.012).两组患者术后24小时所需输血量无显著差异,第一个48小时,或48小时后(p=0.061,0.536,0.442,分别)。在最初的24小时内,两组之间的输血频率相当,第一个48小时,或术后48小时(p=0.277,0.639,0.075,分别)。此外,两组在机械通气的持续时间上没有显着差异,ICU住院时间,住院时间,或死亡率。
结论:对于心脏手术后的儿科患者,闭环采样方法可以有效减少术后PICU随访期间的失血量。然而,它的应用并没有减少这些患者的输血频率或输血量。
OBJECTIVE: The aims of this
study were to assess the impact of the closed-loop sampling method on blood loss and the need for blood transfusion in pediatric patients following cardiac surgery.
METHODS: Retrospective observational
study.
METHODS: A single tertiary center.
METHODS: All pediatric patients younger than 4 years old who were admitted to the pediatric intensive care unit (PICU) after cardiac surgery were enrolled. The
study included 100 pediatric patients in the conservative (postimplementation) group and 43 pediatric patients in the nonconservative group (preimplementation).
METHODS: Observational.
METHODS: The primary outcome was the volume of blood loss during the PICU follow-up period. The secondary outcomes were the requirement for blood transfusion in each group, duration of mechanical ventilation, length of intensive care unit (ICU) stay, length of hospital stay, and mortality.
RESULTS: In the conservative (postimplementation) group, blood loss during the follow-up period was 0.67 (0.33-1.16) mL/kg/d, while it was 0.95 (0.50-2.30) mL/kg/d in the nonconservative (preimplementation) group, demonstrating a significant reduction in blood loss in the conservative group (p = 0.012). The groups showed no significant differences in terms of the required blood transfusion volume postoperatively during the first 24 hours, first 48 hours, or after 48 hours (p = 0.061, 0.536, 0.442, respectively). The frequency of blood transfusion was comparable between the groups during the first 24 hours, first 48 hours, or after 48 hours postoperatively (p = 0.277, 0.639, 0.075, respectively). In addition, the groups did not show significant differences in the duration of mechanical ventilation, length of ICU stay, length of hospital stay, or mortality.
CONCLUSIONS: The closed-loop sampling method can be efficient in decreasing blood loss during postoperative PICU follow-up for pediatric patients after cardiac surgeries. However, its application did not reduce the frequency or the volume of blood transfusion in these patients.