Lu Yanhui, Liu Zhenkui, Li Shiyang, Wang Yanfei, Li Chunmei, Yuan Erwei, Xing Jing, Guo Weiping
Department of Pediatrics, First Affiliated Hospital of Hebei North University, Zhangjiakou Hebei 075000, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2019 Sep 28;44(9):996-1002. doi: 10.11817/j.issn.1672-7347.2019.180372.
To explore the relationship between paediatric early warning score (PEWS) and the occurrence of mechanical ventilation complications in children with acute respiratory distress syndrome (ARDS). Methods: A total of 110 children with ARDS diagnosed in First Affiliated Hospital of Hebei North University, who underwent mechanical ventilation, were selected. The baseline data, blood gas analysis index, laboratory test index, ventilator parameters, pediatric critical illness score (PCIS) and PEWS in the children were recorded. With reference to ventilatory treatment results, the children with ventilator-associated complications were included in the trial group (n=20), while the patients with good cohort status were included in the control group (n=40) according to the nested case-control study. Independent sample t-test and multivariate logistic regression analysis were used to analyze the factors affecting the occurrence of complications after ventilatory treatment. Results: There were statistically significant differences in multiple organ dysfunction syndrome (MODS), partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2), partial pressure of carbon dioxide (PaCO2), serum creatinine (SCr), albumin (ALB), blood urea nitrogen (BUN), mechanical ventilation time, mean article pressure (MAP), tidal volume (VT), positive end-expiratory pressure (PEEP), PCIS, PEWS between the control group and the experimental group (all P<0.05). Multivariate logistic regression analysis showed that MODS, PaO2/FiO2, PaCO2, VT, PEEP and PEWS had influence on complications after mechanical ventilation in children with ARDS (all P<0.05). Conclusion: The MODS, PaO2/FiO2, PaCO2, VT, PEEP, and PEWS exert effects on complications after mechanical ventilation in children with ARDS. PEWS combined with other indicators can assess the risk of complications in children with ARDS after mechanical ventilation.
探讨小儿早期预警评分（PEWS）与急性呼吸窘迫综合征（ARDS）患儿机械通气并发症发生情况之间的关系。方法：选取河北北方学院附属第一医院确诊为ARDS并接受机械通气的110例患儿。记录患儿的基线资料、血气分析指标、实验室检查指标、呼吸机参数、小儿危重病评分（PCIS）及PEWS。参照通气治疗结果，按照巢式病例对照研究，将发生呼吸机相关并发症的患儿纳入试验组（n = 20），将病情良好的患儿纳入对照组（n = 40）。采用独立样本t检验和多因素logistic回归分析，分析通气治疗后影响并发症发生的因素。结果：对照组与试验组在多器官功能障碍综合征（MODS）、氧分压/吸入氧分数（PaO2/FiO2）、二氧化碳分压（PaCO2）、血清肌酐（SCr）、白蛋白（ALB）、血尿素氮（BUN）、机械通气时间、平均气道压（MAP）、潮气量（VT）、呼气末正压（PEEP）、PCIS、PEWS方面比较，差异均有统计学意义（均P < 0.05）。多因素logistic回归分析显示，MODS、PaO2/FiO2、PaCO2、VT、PEEP及PEWS对ARDS患儿机械通气后并发症有影响（均P < 0.05）。结论：MODS、PaO2/FiO2、PaCO2、VT、PEEP及PEWS对ARDS患儿机械通气后并发症有影响。PEWS联合其他指标可评估ARDS患儿机械通气后并发症发生风险。
