Study on the measurement of diaphragm movement by bedside ultrasound guiding the extubation of preschoolers after general anesthesia
Objective To explore the guiding significance of the measurement of diaphragm movement by bedside ultrasound guiding the extubation under deep anesthesia of preschoolers after general anesthesia.Methods A total of 97 preschoolers admitted to the First People's Hospital of Qujing City from January 2020 to December 2022 for limbs surgery under endotracheal intubation and general anesthesia were selected.Based on the extubation outcome,the children were divided into the group without complications after the extubation(Group C)and the group with complications(Group F).The clinical data of the pediatric patients were documented,and bedside ultrasound measurements were taken to assess diaphragm movement preoperatively,post-spontaneous respiratory recovery,immediately after extubation,as well as at 10-minute intervals up to 30 minutes after extubation.Other parameters monitored included vital signs,tidal volume,occurrence of perioperative respiratory complications,Ramsay sedation score,operative time and duration of stay in the resuscitation room.By comparing the differences in observational data between the two groups,we were able to construct a subject-specific recovery curve for diaphragm movement at each time point following surgery.Results There were no statistically significant differences in the baseline data between the two groups(P＞0.05).Significant statistical differences were observed in the recovery of spontaneous respiration immediately after tracheal extubation,as well as at 10 and 20 minutes post-extubation,along with the rate of diaphragm muscle recovery(P＜0.05).The recovery ratio of diaphragm mobility exhibited the largest area under the curve during spontaneous respiration(AUC=0.69,P=0.003),with a sensitivity of 81.8％and specificity of 58.1％.The second largest area was observed during extubation(AUC=0.68,P=0.006),with a sensitivity of 95.5％and specificity of 38.7％.Conclusions The perioperative dynamic assessment of diaphragm function using bedside ultrasound facilitates a straightforward,non-invasive,and radiation-free decision-making process for extubation under deep anesthesia.This approach aids in the early detection and diagnosis of diaphragmatic dysfunction,ultimately improving the prognosis for pediatric patients.
Ultrasound examination of the diaphragmpostoperative deep anesthesia extubationright diaphragm mobilityright di-aphragm mobility recovery ratiodiaphragm function assessment
万方数据
维普
