Udink ten Cate Floris E A, van Royen Barend J, van Heerde Marc, Roerdink Dianne, Plötz Frans B
Department of Paediatric Intensive Care, VU University Medical Center, Amsterdam, The Netherlands.
J Pediatr Orthop B. 2008 Jul;17(4):203-6. doi: 10.1097/BPB.0b013e328301e962.
Patients with neuromuscular scoliosis (NMS) are frequently considered at high risk for postoperative complications based on their underlying disease and comorbidities. Postoperative complications include prolonged mechanical ventilation (MV), defined longer than 72 h, at the paediatric intensive care unit. The objectives of this retrospective study were to assess the incidence of prolonged MV in patients with NMS following scoliosis surgery and to identify predictive risk factors. A total of 46 consecutive patients underwent surgical spinal fusion and instrumentation for progressive NMS. Prolonged MV was required in seven of 46 patients (15%). The only risk factor for prolonged MV was a decreased preoperative pulmonary function. Forced expired volume in 1 s and vital capacity were significantly decreased in patients with MV >72 h compared with patients with MV <72 h. Routine preoperative pulmonary function testing may reveal important information with regard to restrictive lung disease in the preoperative assessment of patients with NMS and predict the early postoperative clinical course.
基于潜在疾病和合并症，神经肌肉型脊柱侧弯（NMS）患者常被视为术后并发症的高危人群。术后并发症包括在儿科重症监护病房机械通气（MV）时间延长，定义为超过72小时。这项回顾性研究的目的是评估脊柱侧弯手术后NMS患者中MV延长的发生率，并确定预测性风险因素。共有46例连续性患者接受了手术性脊柱融合和器械置入术以治疗进展性NMS。46例患者中有7例（15%）需要延长MV。MV延长的唯一风险因素是术前肺功能下降。与MV<72小时的患者相比，MV>72小时的患者1秒用力呼气量和肺活量显著降低。常规术前肺功能测试可能会在NMS患者的术前评估中揭示有关限制性肺病的重要信息，并预测术后早期临床病程。
