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[低心排血量综合征评分用于评估小儿重症监护病房心脏手术后患者]

[Low cardiac output syndrome score to evaluate postoperative cardiac surgery patients in a pediatric intensive care unit].

作者信息

Aslan Nagehan, Yıldızdaş Dinçer, Göçen Uğur, Erdem Sevcan, Demir Fadli, Yontem Ahmet, Horoz Özden Özgür, Sertdemir Yaşar

机构信息

Çukurova University Faculty of Medicine, Department of Pediatric Intensive Care, Adana.

Çukurova University Faculty of Medicine, Department of Pediatric Cardiovascular Surgery, Adana.

出版信息

Turk Kardiyol Dern Ars. 2020 Jul;48(5):504-513. doi: 10.5543/tkda.2020.13844.

Abstract

OBJECTIVE

There is no clear consensus regarding the definition of low cardiac output syndrome (LCOS) or the follow-up of this patient group. Given this lack of a clinical definition, the aim of this study was to use a LCOS score (LCOSs) similar to the low cardiac output score previously presented in the literature and evaluate the relationship between a high LCOSs and poor clinical outcome.

METHODS

A total of 54 patients were prospectively evaluated after cardiac surgery. The LCOSs was used to evaluate the deve-lopment of low cardiac output. Each parameter was scored as 1 point. The score was calculated every hour for 24 hours postoperatively and the highest score was recorded as the peak score (pLOCSs). The LOCSs at the time of admission to the pediatric intensive care unit, at the 4th, 8th, and 16th hour were recorded and a cumulative score (cLOCSs) score was calculated.

RESULTS

The mean age of the patients was 49.40±53.15 months and 24.07% had LOCS. In the group with LCOS, the cLOCSs, vasoactive-ınotropic score (VIS), lactate mean, aortic clamp time, and the total cardiopulmonary bypass time were significantly higher. In this study, a significant and positive correlation was found between the cLOCSs and pLOCSs and the length of hospital stay, length of stay in the pediatric intensive care unit, VIS, lactate mean, and aortic clamp duration.

CONCLUSION

The objective of this study was to draw attention to the potential use of a common language in the care of critical pediatric patients undergoing cardiac surgery with a previously defined scoring method that includes parameters indicating poor perfusion in the patient.

摘要

目的

关于低心排血量综合征(LCOS)的定义或该患者群体的随访尚无明确共识。鉴于缺乏临床定义,本研究的目的是使用一种类似于先前文献中提出的低心排血量评分的LCOS评分(LCOSs),并评估高LCOSs与不良临床结局之间的关系。

方法

对54例心脏手术后的患者进行前瞻性评估。LCOSs用于评估低心排血量的发展情况。每个参数计1分。术后24小时每小时计算一次评分,并将最高评分记录为峰值评分(pLOCSs)。记录患儿入住儿科重症监护病房时、第4、8和16小时的LOCSs,并计算累积评分(cLOCSs)。

结果

患者的平均年龄为49.40±53.15个月,24.07%的患者出现LCOS。在LCOS组中,cLOCSs、血管活性药物-正性肌力药物评分(VIS)、平均乳酸水平、主动脉阻断时间和体外循环总时间显著更高。在本研究中,发现cLOCSs和pLOCSs与住院时间、儿科重症监护病房住院时间、VIS、平均乳酸水平和主动脉阻断持续时间之间存在显著正相关。

结论

本研究的目的是通过一种先前定义的评分方法,引起人们对在接受心脏手术的危重症儿科患者护理中使用通用语言的潜在关注,该评分方法包括指示患者灌注不良的参数。

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