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拔管时间对新生儿心脏手术后喂养结局的影响:一项单中心研究

Impact of Extubation Time on Feeding Outcomes after Neonatal Cardiac Surgery: A Single-Center Study.

作者信息

Kepple Jeffrey W, Kendall Meghan, Ortmann Laura A

机构信息

Department of Pediatrics, Creighton University School of Medicine, 2500 California Plaza, Omaha, NE 68178, USA.

Department of Pediatrics, University of Nebraska Medical Center, 42nd and Emile, Omaha, NE 68198, USA.

出版信息

Children (Basel). 2023 Mar 20;10(3):592. doi: 10.3390/children10030592.

Abstract

This study aimed to examine the impact of timing of extubation on feeding outcomes in neonates after surgery for congenital heart disease. This was a single-center retrospective study between December 2014 and June 2020. Patients were divided into three categories: extubated in the OR (immediate), extubated in the intensive care unit (ICU) between 0 and 3 days post-procedure (early), and extubated >3 days post-procedure (delayed). Comparing the immediate and early groups, we found no difference in time to first enteral feed (1.3 days (1.0-3.4) vs. 2.3 days (1.1-3.3), = 0.27). There was no difference in time to first oral feed (2.0 days (1.1-4.5) vs. 3.1 days (1.8-4.4), = 0.34) and time to goal feed (6.0 days (3.2-8.3) vs. 6.9 days (5.0-9.0), = 0.15)). There was no difference in all oral feeds at one year: 88% vs. 98%, = 0.16. The delayed extubation group performed significantly worse on all measures. Immediate and early extubation displayed no differences in feeding outcomes and length of stay in this study, while delayed extubation performed worse on all measures. Thus, we believe that clinicians should emphasize extubation within 3 days post-surgery to improve feeding outcomes while minimizing time hospitalized.

摘要

本研究旨在探讨先天性心脏病手术后新生儿拔管时机对喂养结局的影响。这是一项2014年12月至2020年6月间的单中心回顾性研究。患者分为三类:在手术室拔管(即刻)、术后0至3天内在重症监护病房(ICU)拔管(早期)、术后3天以上拔管(延迟)。比较即刻拔管组和早期拔管组,我们发现首次肠内喂养时间无差异(1.3天(1.0 - 3.4)对2.3天(1.1 - 3.3),P = 0.27)。首次经口喂养时间(2.0天(1.1 - 4.5)对3.1天(1.8 - 4.4),P = 0.34)和达到目标喂养时间(6.0天(3.2 - 8.3)对6.9天(5.0 - 9.0),P = 0.15)也无差异。1岁时全经口喂养情况无差异:88%对98%,P = 0.16。延迟拔管组在所有指标上表现明显更差。在本研究中,即刻拔管和早期拔管在喂养结局和住院时间方面无差异,而延迟拔管在所有指标上表现更差。因此,我们认为临床医生应强调术后3天内拔管,以改善喂养结局并尽量缩短住院时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3ba/10047081/7b16b17dd1f6/children-10-00592-g001.jpg

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