摘要
目的探讨脑电双频指数(BIS)在婴儿先天性心脏病术后呼吸机撤离中的应用及指导价值。方法回顾性分析2022年1月至2023年11月在徐州医科大学附属徐州儿童医院诊治的先天性心脏病婴儿81例,按照呼吸机撤离成功与否分为成功撤离组(62例)和失败撤离组(19例)。采用单因素和多因素Logistic回归分析两组患儿的临床资料,绘制ROC曲线分析BIS对婴儿先天性心脏病术后呼吸机撤离失败的预测价值。结果两组患儿机械通气时间,ICU滞留时间,住院时间及镇静后1 h、2 h、3 h、4 h、5 h的BIS比较差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,镇静后1 h、2 h、3 h、4 h、5 h的BIS是婴儿先天性心脏病术后呼吸撤离失败影响因素(P<0.05);ROC曲线分析得出,镇静后1 h、2 h、3 h、4 h、5 h的BIS,联合预测婴儿先天性心脏病术后呼吸机撤离失败的AUC分别为0.886、0.877、0.873、0.907、0.925、0.954,敏感度、特异度分别为94.7%、67.7%,84.2%、93.5%,84.2%、83.9%,89.5%、79.0%,84.2%、85.5%,联合为100.0%、90.3%。结论在婴儿先天性心脏病术后呼吸机撤离中开展BIS监测,对呼吸机撤离成功与否有一定的预测价值。
Objective To explore the application and guiding value of bispectral index(BIS)in postoperative ventilator weaning in infants with congenital heart disease.Methods A retrospective analysis was conducted on 81 cases of infants with congenital heart disease treated at Xuzhou Children's Hospital affiliated with Xuzhou Medical University from January 2022 to November 2023.The infants were divided into the successful weaning group(62 cases)and the failed weaning group(19 cases)based on the success of ventilator withdrawal.Univariate and multivariate Logistic analyses were performed on the clinical data of the two groups of infants,and ROC curves were plotted to analyze the predictive value of BIS for postoperative ventilator withdrawal failure in infants with congenital heart disease.Results The mechanical ventilation time,ICU stay time,hospitalization time,and BIS values at 1 hour,2 hours,3 hours,4 hours,and 5 hours after sedation in the two groups of infants showed statistically significant differences(P<0.05).The results of the multivariate Logistic regression analysis indicated that BIS values at 1 hour,2 hours,3 hours,4 hours,and 5 hours after sedation are factors affecting the failure of postoperative ventilator weaning in infants with congenital heart disease(P<0.05).The ROC curve analysis revealed that the AUCs for predicting postoperative ventilator weaning failure in infants with congenital heart disease were 0.886,0.877,0.873,0.907,0.925,and 0.954 for BIS at 1 hour,2 hours,3 hours,4 hours,and 5 hours after sedation,and the combined prediction,respectively.The sensitivities and specificities were as follows:for BIS at 1 hour after sedation,94.7%and 67.7%;for BIS at 2 hours after sedation,84.2%and 93.5%;for BIS at 3 hours after sedation,84.2%and 83.9%;for BIS at 4 hours after sedation,89.5%and 79.0%;for BIS at 5 hours after sedation,84.2%and 85.5%;and for the combined prediction,100.0%and 90.3%.Conclusion The use of BIS monitoring during the weaning of ventilators in infants after congenital heart disease surgery has certain predictive value for the success of the weaning process.
作者
李青
张琦
何飞
周珂如
郭士勇
张冲
Li Qing;Zhang Qi;He Fei;Zhou Keru;Guo Shiyong;Zhang Chong(Department of Cardiac and Thoracic Surgery Intensive Care Unit,Xuzhou Children's Hospital Affiliated to Xuzhou Medical University,Xuzhou 221000,China;Cardiovascular Center,The Second Affiliated Hospital of Nanjing Medical University,Nanjing 210011,China)
出处
《中国小儿急救医学》
2025年第10期773-777,共5页
Chinese Pediatric Emergency Medicine
基金
徐州儿童医院科研项目(22040412)。
关键词
先天性心脏病
脑电双频指数
呼吸机撤离
预测
Congenital heart disease
Bispectral index
Ventilator weaning
Prediction
