儿科患者在镇静状态下接受影像学检查发生肺不张的相关因素:单一中心队列的回顾性研究

2021
09/15

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儿科患者在镇静状态下接受影像学检查发生肺不张的相关因素:单一中心队列的回顾性研究



摘要


镇静可引起肺不张,这可能导致图像质量不佳。本研究旨在确定儿童患者在镇静状态下接受影像学检查期间肺不张发生的相关因素。年龄<18岁的患者在异丙酚或右美托咪定镇静下接受全身磁共振成像(MRI)检查。通过胸部水平的冠状面短tau倒置恢复图像进行视觉和定量评估肺不张的发展。进行多变量逻辑回归分析,以确定与肺不张发展相关的独立因素。91例患者被纳入分析。在多变量分析中,给予补充氧气是唯一与发生肺不张显著相关的因素(调整后的几率比,4.84;95%置信区间,1.48-15.83;P = 0.009)。单变量分析显示,使用右美托咪定与肺不张的发生率较低有关;然而,这无法在多变量分析中得到验证。在镇静状态下接受影像学检查的儿童患者中,补充氧气是与肺不张发生相关的唯一独立因素。需要进行前瞻性临床试验,以确定给氧与镇静期间肺不张发生之间的因果关系。



原始文献来源


Pyeong Hwa Kim, Yong-Seok Park , Hee-Mang Yoon,et al.Factors Associated with Occurrence of Atelectasis during Sedation for Imaging in Pediatric Patients: A Retrospective Single Center Cohort Study.J Clin Med 2021 Aug 16;10(16).



Factors Associated with Occurrence of Atelectasis during Sedation for Imaging in Pediatric Patients: A Retrospective Single Center Cohort Study

Sedation can induce atelectasis which may cause suboptimal image quality. This study aimed to identify factors associated with the occurrence of atelectasis during sedation for imaging in pediatric patients. Patients < 18 years who had undergone whole-body magnetic resonance imaging (MRI) under sedation with propofol or dexmedetomidine were included in this study. The development of atelectasis was visually and quantitatively assessed by coronal short tau inversion recovery images of the thoracic level. Multivariable logistic regression was performed to identify the independent factors associated with the development of atelectasis. Ninety-one patients were included in the analysis. In the multivariable analysis, administration of supplemental oxygen was the only factor significantly associated with the occurrence of atelectasis (adjusted odds ratio, 4.84; 95% confidence interval, 1.48–15.83; p = 0.009). Univariable analysis showed that the use of dexmedetomidine was associated with a lower incidence of atelectasis; however, this could not be verified in the multivariable analysis. Among the pediatric patients who had undergone imaging under sedation, additional oxygen supplementation was the only independent factor associated with atelectasis occurrence. A prospective clinical trial is required to identify the cause-effect relationship between oxygen administration and occurrence of atelectasis during sedation.

 

 

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关键词:
影像学,多变量,儿科,检查,分析,确定

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