Wang Zengchun, Chen Qiang, Yu Lingshan, Huang Yu, Cao Hua
Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350005, China.
Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian 350005, China.
Evid Based Complement Alternat Med. 2021 Oct 18;2021:4802389. doi: 10.1155/2021/4802389. eCollection 2021.
We randomly divided 200 children with severe pneumonia who met the indications for tracheal intubation into 2 groups in this prospective study. One group that received dexmedetomidine for sedation was recorded as the dexmedetomidine group ( = 100), and the group that received midazolam for sedation was recorded as the midazolam group ( = 100). We compared the anesthesia sedation scores, time to fall asleep, time to wake up from anesthesia, related hemodynamic parameters, and adverse reactions between the two groups of children. The failure mode and effect analysis method (FMEA) was also used to investigate the causes of unplanned extubation (UEX) of tracheal intubation in 32 children with severe pneumonia. Our conclusion is as follows: (1) Compared with midazolam, the comprehensive effect of dexmedetomidine on children with severe pneumonia undergoing tracheal intubation for anesthesia and sedation is better, it can effectively shorten the anesthesia induction time and the recovery time after stopping the drug, and there are few adverse reactions, which is worthy of application and promotion. (2) UEX is an important risk factor in the monitoring and nursing of children with severe pneumonia tracheal intubation, and the nursing method of PDCA cycle management is particularly important for them.
在这项前瞻性研究中，我们将200名符合气管插管指征的重症肺炎患儿随机分为两组。其中一组接受右美托咪定镇静，记录为右美托咪定组（n = 100）；另一组接受咪达唑仑镇静，记录为咪达唑仑组（n = 100）。我们比较了两组患儿的麻醉镇静评分、入睡时间、麻醉苏醒时间、相关血流动力学参数及不良反应。还采用失效模式与效应分析方法（FMEA）对32例重症肺炎气管插管患儿意外拔管（UEX）的原因进行调查。我们的结论如下：（1）与咪达唑仑相比，右美托咪定用于重症肺炎气管插管患儿麻醉镇静的综合效果更好，能有效缩短麻醉诱导时间和停药后的恢复时间，且不良反应少，值得应用推广。（2）UEX是重症肺炎气管插管患儿监护中的重要危险因素，采用PDCA循环管理的护理方法对其尤为重要。
