Lin Albert Y, Habib Anthony, Ko Riva, Jerome E Heidi, Gou Wenhao, Wang Shuang, Sun Lena S
Departments of Anesthesiology.
Department of Biostatistics, Mailman School of Public Health, Columbia University.
J Neurosurg Anesthesiol. 2023 Jan 1;35(1):160-165. doi: 10.1097/ANA.0000000000000883. Epub 2022 Dec 6.
It has been suggested that anesthesiologists with subspecialty expertise in pediatric cardiac anesthesia are best qualified to care for patients with complex congenital cardiac anomalies and manage the complex physiology frequently encountered in the pediatric cardiac catheterization lab. We evaluated the incidence of adverse events in our pediatric cardiac catheterization lab, comparing care provided by cardiac and noncardiac pediatric attending anesthesiologists.
Data were collected on each anesthetic in the pediatric cardiac catheterization lab from January 1, 2016 to December 31, 2019. A generalized linear mixed effect model was used to identify associations between pediatric cardiac and noncardiac anesthesiologists and the presence of adverse events adjusting for age, American Society of Anesthesiologists physical status, emergency status, and interventional versus diagnostic procedures.
A total of 3,761 procedures involving 1,729 patients were included in the study. There was no significant difference between noncardiac and cardiac anesthesia attendings for overall adverse events (odds ratio [OR], 1.2; 95% confidence interval [CI], 0.82 to 1.75 P=0.349). Specific respiratory adverse events (OR, 1.22; 95%, CI 0.73 to 2.03 P=0.443) or cardiac adverse events (OR, 1.26; 95% CI, 0.64 to 2.48 P=0.502) were also not significantly different with respect to noncardiac compared with cardiac attending anesthesiologists.
In our analysis, the incidence of adverse events in the pediatric cardiac catheterization lab during the study period was not statistically different, whether anesthesia care was provided by a cardiac or a noncardiac anesthesiologist.
有人认为，在小儿心脏麻醉方面具有亚专业专长的麻醉医生最有资格护理患有复杂先天性心脏异常的患者，并处理小儿心脏导管实验室中经常遇到的复杂生理问题。我们评估了我们小儿心脏导管实验室中不良事件的发生率，比较了心脏科和非心脏科小儿主治麻醉医生提供的护理。
收集了2016年1月1日至2019年12月31日期间小儿心脏导管实验室中每次麻醉的数据。使用广义线性混合效应模型来确定小儿心脏科和非心脏科麻醉医生与不良事件之间的关联，并对年龄、美国麻醉医师协会身体状况、紧急状态以及介入与诊断程序进行调整。
该研究共纳入了涉及1729名患者的3761例手术。非心脏麻醉和心脏麻醉的主治医生在总体不良事件方面没有显著差异（优势比[OR]，1.2；95%置信区间[CI]，0.82至1.75；P=0.349）。与心脏科主治麻醉医生相比，非心脏科主治麻醉医生在特定呼吸不良事件（OR，1.22；95%CI，0.73至2.03；P=0.443）或心脏不良事件（OR，1.26；95%CI，0.64至2.48；P=0.502）方面也没有显著差异。
在我们的分析中，在研究期间，无论麻醉护理是由心脏科还是非心脏科麻醉医生提供，小儿心脏导管实验室中不良事件的发生率在统计学上没有差异。
