Priebe Claudia, Bosse Hans Martin, Michael Mark, Picker Olaf, Bernhard Michael, Tautz Juliane
Klinik für Allgemeine Pädiatrie, Kinderkardiologie und Neonatologie, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität, Moorenstraße 5, Düsseldorf, 40225, Deutschland.
Zentrale Notaufnahme, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität, Moorenstraße 5, 40225, Düsseldorf, Deutschland.
Anaesthesiologie. 2024 Oct;73(10):656-667. doi: 10.1007/s00101-024-01457-7. Epub 2024 Sep 2.
The establishment of a resuscitation room management for nontraumatic critically ill children appears to make sense. This study collected data of pediatric patients suffering from nontraumatic critically ill conditions treated in a resuscitation room.
The retrospective OBSERvE-DUS-PED study (November 2019-October 2022) recorded pediatric patients (age < 18 years) who were admitted to the emergency department (ED) for resuscitation room care. The routinely documented data on treatment were taken from the hospital information system MEDICO® and the patient data management system COPRA® in accordance with the OBSERvE dataset. The study was approved by the Ethics Committee of the Medical Faculty of the Heinrich Heine University (2023-2377).
The study included 52 pediatric resuscitation room patients. Adolescents aged 14-17 years were the most frequent in the cohort representing 37% of the total and neonates/infants (0-1 year) were lowest at 8%. The most common symptoms categorized according to ABCDE problems were disturbance of consciousness (D) at 61%, cardiovascular failure (C) at 25%, respiratory insufficiency (B) at 6%, airway obstruction (A) and exposure/environment (E) problems each at 4%. The out-of-hospital and in-hospital emergency procedures were performed with the following frequencies: venous (58% vs. 65%), intraosseous (14% vs. 2%) and central venous access (0% vs. 12%), invasive airway management (35% vs. 8%), cardiopulmonary resuscitation (21% vs. 10%), vasopressors (15% vs. 17%), and intra-arterial pressure measurement (0% vs. 17%). The mean duration of resuscitation room management was 70 ± 43 min. The 30-day mortality was 17%.
The OBSERvE-DUS-PED study demonstrates the major challenges in the care of critically ill nontraumatic pediatric patients, both in out-of-hospital and in-hospital management. The variety and complexity of the referral diagnoses as well as the immediate vital threat to the patients make it appear sensible to treat such patients primarily in a resuscitation room of the ED due to the available material, infrastructural and personnel resources.
为非创伤性危重症儿童建立复苏室管理似乎是有意义的。本研究收集了在复苏室接受治疗的非创伤性危重症儿科患者的数据。
回顾性OBSERvE-DUS-PED研究（2019年11月至2022年10月）记录了因复苏室护理而入住急诊科（ED）的儿科患者（年龄<18岁）。按照OBSERvE数据集，从医院信息系统MEDICO®和患者数据管理系统COPRA®中获取常规记录的治疗数据。该研究获得了海因里希·海涅大学医学院伦理委员会的批准（2023-2377）。
该研究纳入了52名儿科复苏室患者。14-17岁的青少年在队列中最为常见，占总数的37%，新生儿/婴儿（0-1岁）最少，占8%。根据ABCDE问题分类的最常见症状为意识障碍（D），占61%，心血管衰竭（C），占25%，呼吸功能不全（B），占6%，气道阻塞（A）和暴露/环境（E）问题各占4%。院外和院内急救程序的执行频率如下：静脉通路（58%对65%）、骨内通路（14%对2%）和中心静脉通路（0%对12%）、有创气道管理（35%对8%）、心肺复苏（21%对10%）、血管加压药（15%对1
