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床旁超声在心脏手术后呼吸困难儿童诊断与治疗中的应用

Bedside Ultrasound in the Diagnosis and Treatment of Children with Respiratory Difficulty Following Cardiac Surgery.

作者信息

Hamadah Hussam Kanaan, Kabbani Mohamed Salim

机构信息

King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Kingdom of Saudi Arabia.

King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia.

出版信息

J Clin Imaging Sci. 2017 Sep 22;7:37. doi: 10.4103/jcis.JCIS_42_17. eCollection 2017.

DOI:10.4103/jcis.JCIS_42_17
PMID:29026677
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5634065/
Abstract

Many children frequently fail extubation or require a prolonged period of positive pressure ventilation support after cardiac surgery. Pediatric cardiac Intensive Care Unit (PCICU) ultrasound (US) stands as a simple, basic bedside tool that can be performed by trained intensivists for the diagnosis with immediate implication on therapeutic decisions in multiple scenarios that physicians may face in PCICU. Bedside US is widely available, convenient, and inexpensive. This educational article based mainly on our own experience is highlighting the role of US in detecting the most common causes of respiratory weaning difficulties and extubation failure in postoperative cardiac children through proposed illustration and algorithm.

摘要

许多儿童在心脏手术后经常拔管失败或需要长时间的正压通气支持。儿科心脏重症监护病房（PCICU）超声（US）是一种简单的床边基本工具，经过培训的重症监护医生可以使用它进行诊断，这对医生在PCICU可能面临的多种情况下的治疗决策具有直接影响。床边超声广泛可用、方便且价格低廉。这篇主要基于我们自身经验的教育性文章，通过示例和流程，突出了超声在检测心脏术后儿童呼吸脱机困难和拔管失败最常见原因方面的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e961/5634065/1516790027b1/JCIS-7-37-g022.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e961/5634065/5db45a94b6c5/JCIS-7-37-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e961/5634065/cd6a0ca1625d/JCIS-7-37-g012.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e961/5634065/b21cb84ab831/JCIS-7-37-g013.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e961/5634065/066efa8a6083/JCIS-7-37-g014.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e961/5634065/edf11e5899d7/JCIS-7-37-g016.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e961/5634065/dd85a425d630/JCIS-7-37-g017.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e961/5634065/94e6643b624b/JCIS-7-37-g018.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e961/5634065/142b1465ba90/JCIS-7-37-g020.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e961/5634065/e0f37adbeaa6/JCIS-7-37-g021.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e961/5634065/1516790027b1/JCIS-7-37-g022.jpg

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本文引用的文献

1
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Cardiol Young. 2017 Apr;27(3):452-458. doi: 10.1017/S1047951116000718. Epub 2016 May 10.
2
Lung ultrasound in adult and paediatric cardiac surgery: is it time for routine use?成人及小儿心脏手术中的肺部超声：是时候常规使用了吗？
Interact Cardiovasc Thorac Surg. 2016 Feb;22(2):208-15. doi: 10.1093/icvts/ivv315. Epub 2015 Nov 18.
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Clinical Epidemiology of Extubation Failure in the Pediatric Cardiac ICU: A Report From the Pediatric Cardiac Critical Care Consortium.
儿科心脏重症监护病房拔管失败的临床流行病学：来自儿科心脏重症监护联盟的报告。
Pediatr Crit Care Med. 2015 Nov;16(9):837-45. doi: 10.1097/PCC.0000000000000498.
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Pericardial effusion after pediatric cardiac surgeries: a single center observation.小儿心脏手术后的心包积液：单中心观察
Res Cardiovasc Med. 2012 Nov;1(1):28-32. doi: 10.5812/cardiovascmed.4601. Epub 2012 Nov 1.
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Lung ultrasound in the intensive care unit: let's move forward.重症监护病房中的肺部超声：让我们继续前进。
Intensive Care Med. 2014 Oct;40(10):1592-4. doi: 10.1007/s00134-014-3484-4. Epub 2014 Sep 18.
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Lung ultrasound in the critically ill.重症患者的肺部超声。
Ann Intensive Care. 2014 Jan 9;4(1):1. doi: 10.1186/2110-5820-4-1.
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A single-center experience of extubation failure in infants undergoing the Norwood operation.婴儿行 Norwood 手术中发生拔管失败的单中心经验
Ann Thorac Surg. 2012 Oct;94(4):1262-8. doi: 10.1016/j.athoracsur.2012.05.033. Epub 2012 Jul 11.
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International evidence-based recommendations for point-of-care lung ultrasound.国际即时护理肺部超声推荐意见
Intensive Care Med. 2012 Apr;38(4):577-91. doi: 10.1007/s00134-012-2513-4. Epub 2012 Mar 6.
9
Lung ultrasound in critically ill patients: comparison with bedside chest radiography.重症患者肺部超声：与床边胸部 X 线摄影的比较。
Intensive Care Med. 2011 Sep;37(9):1488-93. doi: 10.1007/s00134-011-2317-y. Epub 2011 Aug 2.
10
Passive peritoneal drainage improves fluid balance after surgery for congenital heart disease.被动性腹腔引流可改善先天性心脏病手术后的液体平衡。
Eur J Cardiothorac Surg. 2012 Feb;41(2):256-60. doi: 10.1016/j.ejcts.2011.05.037. Epub 2011 Dec 12.