de Graaff Jurgen C
Department of Anesthesia, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Curr Opin Anaesthesiol. 2018 Jun;31(3):313-319. doi: 10.1097/ACO.0000000000000594.
Blood pressure is a basic feature of monitoring during anaesthesia. However, it is very unclear what blood pressures are normal during anaesthesia in children. Furthermore, the clinical consequences of low blood pressure are also uncertain. Similarly, it is unclear when to initiate therapy for hypotension during anaesthesia. This review summarizes the most recent development on the interpretation of blood pressure measurements in children and the relation of low blood pressure to clinical outcome.
Recently published (multicentre) database studies show that alleged complications of intraoperative hypotension (brain ischaemia, kidney dysfunction, myocardial ischaemia and multiple organ dysfunction) are very rare in children after anaesthesia noncardiac procedures. Furthermore, other studies show that a considerable number of patients have blood pressure lower than a threshold according to the current standards treatment of Paediatric Life Support.
The recently published reference tables can guide anaesthesiologist in daily practice to define intraoperative hypotension. However, there are situations in which a higher blood pressure is recommendable and an individual approach is required.
血压是麻醉期间监测的一项基本指标。然而，儿童麻醉期间的正常血压范围很不明确。此外，低血压的临床后果也不确定。同样，麻醉期间何时开始治疗低血压也不明确。本综述总结了儿童血压测量解读以及低血压与临床结局关系方面的最新进展。
最近发表的（多中心）数据库研究表明，在儿童非心脏手术麻醉后，术中低血压的所谓并发症（脑缺血、肾功能障碍、心肌缺血和多器官功能障碍）非常罕见。此外，其他研究表明，相当数量的患者血压低于当前儿科生命支持标准治疗的阈值。
最近公布的参考表格可在日常实践中指导麻醉医生定义术中低血压。然而，在某些情况下，较高的血压是可取的，需要采取个体化方法。
