非插管创伤儿童的程序性镇静 - 单中心研究。

Procedural sedation in non-intubated children with severe trauma - A single center study.

机构信息

Department of Pediatrics, Kaplan Medical Center, Rehovot, Israel.

Emergency Department, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel; Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel.

出版信息

Am J Surg. 2019 Jul;218(1):95-99. doi: 10.1016/j.amjsurg.2018.08.016. Epub 2018 Aug 27.

DOI:10.1016/j.amjsurg.2018.08.016

PMID:30177239

Abstract

BACKGROUND

Non-intubated children frequently undergo emergent procedures in the trauma-bay. This study evaluates whether patients treated with procedural sedation have an increased risk for severe adverse events.

METHODS

Retrospective analysis of 1182 children with an injury severity score (ISS) of greater than 15.

RESULTS

Of the 565 patients who were spontaneously breathing on arrival, 455 were hemodynamically stable with a Glasgow Coma Score of 15, 201 of whom were treated with sedation; 144 (71.6%) had computerized tomography scan, 35 (17.5%) wound debridement, and 22 (10.9%) fracture reduction. Sedation patients had an ISS of 20 (interquartile range 17-25). There were no death cases, no cases of cardiopulmonary resuscitation, and no cases of neurologic sequelae on hospital discharge. There were 2 (1%) cases of unanticipated endotracheal intubation.

CONCLUSIONS

Non-intubated patients who were hemodynamically stable with a Glasgow Coma Score of 15 had a low risk for severe adverse events due to sedation.

摘要

背景

非插管的儿童常在创伤室接受紧急手术。本研究评估了在接受镇静治疗的患者中，严重不良事件的发生率是否更高。

方法

对损伤严重程度评分（ISS）大于 15 的 1182 例儿童进行回顾性分析。

结果

在 565 名到达时自主呼吸的患者中，455 名血流动力学稳定，格拉斯哥昏迷评分（GCS）为 15，其中 201 名接受了镇静治疗；144 名（71.6%）进行了计算机断层扫描，35 名（17.5%）进行了清创，22 名（10.9%）进行了骨折复位。镇静治疗患者的 ISS 为 20（四分位距 17-25）。无死亡病例，无心肺复苏病例，无出院时神经系统后遗症病例。有 2 例（1%）出现意外气管插管。