摘要
Background:Ketamineisappliedwidelyforsedationduringcardiaccatheterizationinspontaneouslybreathingchildrenwithcongenitalheartdisease(CHD).However,arareandunreportedrespiratorycomplication,transientandreversibleatelectasisoflungs(TRAL),wasidentified.Purpose:ThestudywasperformedtoinvestigateretrospectivelytheprevalenceandclinicalcharacteristicsofTRALafterketaminesedationinpediatriccardiaccatheterization.Methods:Fourthousandfourhundredandseventy-foursickchildrenweresedatedwithketamine,andpediatriccardiaccatheterizationwascarriedoutunderspontaneousbreathing.TRALwasdetectedin33children(17M/16F,agewas2.1±1.7years)byretrospectiveanalysis.Theclinicalandradiographiccharacteristicswererecordedbefore,duringandafterTRAL.Results:Inpediatriccardiaccatheterization,theprevalenceofTRALwas0.74%afterketaminesedation.TRALoccurredin23childrenwithcyanoticCHD,and10withacyanoticCHD.AllTRALshadcommonclinicalandradiographicfeatures:thediffuseopacityofbilaterallungsdevelopedrapidly(identifiedunderX-rayfluoroscopy),associatedwithdecreaseinlungvolume,andthenthedecreaseinSpO2(94.2±9.2%vs.59.4±2.2%,P<0.05),andheartrates(143.5±14.3bpmvs.58.3±9.7bpm,P<0.05)followedquickly.TRALwasrelievedbysupportiveoxygenin32children(23withfacemask,and9withendotrachealintubation),andthedurationofTRALwas1.6±0.5minutes.However,TRALcausedthedeathofonechild.Conclusions:TRALisarareandurgentrespiratorycomplicationafterketaminesedation,andthemechanismisunclear.RapidanddiffuseopacityofbilaterallungsistheearliestsignofTRALinpediatriccardiaccatheterization,andtheimmediatesupportiveoxygeniscrucial.
出版日期
2016年08月13日（中国期刊网平台首次上网日期，不代表论文的发表时间）
