转运呼吸机在危重患儿院际转运中的应用研究

Application of transport ventilator in the inter-hospital transport of critically ill children

目的 探讨转运呼吸机在危重患儿院际转运过程中的应用价值。方法 选择湖南省儿童医院2018年1月-2019年1月未使用转运呼吸机转运和2019年1月-2020年1月使用转运呼吸机转运的危重患儿分别作为对照组(n=120)和观察组(n=122),对两组病例的一般情况,转运途中心率、呼吸、经皮血氧饱和度变化,不良事件发生情况和转归进行对比分析。结果 转运前两组患儿性别、年龄、氧合指数(PaO_(2)/FiO_(2))、小儿危重病例评分、转运前病程、原发疾病、心率、呼吸、经皮血氧饱和度的比较差异均无统计学意义(P>0.05)。转运途中两组患儿心率、呼吸、经皮血氧饱和度的比较差异无统计学意义(P>0.05);观察组气管导管脱管、留置针脱出、心搏骤停发生率低于对照组,差异无统计学意义(P>0.05)。观察组机械通气时间、儿童重症监护病房住院时间较对照组缩短,转运成功率、治愈及好转率较对照组升高,差异有统计学意义(P<0.05)。结论 转运呼吸机在危重患儿院际转运中的应用可在一定程度上协助提高院际转运的成功率,改善危重患儿的预后,值得在院际转运中推广。

Objective To study the application value of transport ventilator in the inter-hospital transport of critically ill children.Methods The critically ill children in Hunan Children’s Hospital who were transported with or without a transport ventilator were included as the observation group(from January 2019 to January 2020;n=122) and the control group(from January 2018 to January 2019;n=120),respectively.The two groups were compared in terms of general data,the changes in heart rate,respiratory rate,and blood oxygen saturation during transport,the incidence rates of adverse events,and outcomes.Results There were no significant differences between the two groups in sex,age,oxygenation index,pediatric critical illness score,course of disease,primary disease,heart rate,respiratory rate,and transcutaneous oxygen saturation before transport(P>0.05).During transport,there were no significant differences between the two groups in the changes in heart rate,respiratory rate,and transcutaneous oxygen saturation(P>0.05).The incidence rates of tracheal catheter detachment,indwelling needle detachment,and sudden cardiac arrest in the observation group were lower than those in the control group during transport,but the difference was not statistically significant(P>0.05).Compared with the control group,the observation group had significantly shorter duration of mechanical ventilation and length of stay in the pediatric intensive care unit and significantly higher transport success rate and cure/improvement rate(P<0.05).Conclusions The application of transport ventilator in the inter-hospital transport can improve the success rate of inter-hospital transport and the prognosis in critically ill children,and therefore,it holds promise for clinical application in the inter-hospital transport of critically ill children.