Dynamic Study Of The Effect Of Bronchoalveolar Lavage On Electrocardiogram In Children With Severe Pneumonia

Objective:To observe the changes of ECG in different periods of bronchoalveolar lavage(BAL)in children with severe pneumonia,to explore the effect of BAL on cardiac conduction and rhythm in children with severe pneumonia,and to further study the related factors affecting the abnormality of BAL center electrical parameters,moreover to help BAL surgery center electrical indicators figure out abnormal prevention measuresMethods:This study used a prospective study,continuous sampling method,to select children who were eligible for inclusion in the Dalian Children's Hospital respiratory department from August 2016 to June 2017,who were diagnosed with severe pneumonia and who underwent BAL.Before BAL,after anesthesia,into the mirror,into the lavage fluid,after the appearance of the lens,and 1 day after the operation,the electrocardiogram of the child was collected,and the percutaneous oxygen saturation of the child was measured.The heart rate,rhythm and P wave of the ECG of the child were measured.Amplitude and width,PR interval,QRS wave shapes and width,ST segment changes,T wave changes as well.Multivariate analysis of children with abnormal electrical parameters in the BAL center and summary of prevention and treatment measures.This study used the SPSS20.0 statistical tool to apply univariate analysis of factors that may lead to abnormal ECG indicators:age,weight,lavage site,operative time,number of operations,percutaneous oxygen saturation,immediate post-coction of carbon dioxide,mycoplasma Infection,combined complications were statistically analyzed,and statistically significant multivariate logistic regression analysis was performed to select high-risk factors for abnormal BAL arterial parameters.P<0.05 was considered statistically significantResult:1.There were no ECG abnormalities in the electrocardiogram of 169 children with BAL.A total of 93 children had abnormal ECG,the incidence rate was 55.30%,a total of 2 patients had abnormal ECG after operation,and the incidence rate was 1.18%.In this way,this difference was statistically significant by?2 test.2.Among the 169 children with BAL,93 had abnormal ECG,and there were 159 abnormalities of ECG in the operation.39 cases of premature beats,accounting for 24.83%,including 32 cases in early room and 7 cases in early house.There were 24 cases of IRBBB,the incidence rate was 15.09%;48 cases of I°atrioventricular block occurred,the incidence rate was 30.19%;48 cases of ST-T changes occurred,the incidence rate was 30.19%;3.Uni variate analysis showed that the abnormality of the BAL center electrical index compared with the normal group compared the body weight,number of operations,surgical site,and factors related to mycoplasma infection.and the difference was not statistically significant by?2 test.4.Univariate analysis showed that the age of the abnormality group of the BAL center and the normal group were compared with the normal group.The difference was statistically significant byxZ test.5.Univariate analysis showed that the operation time of the abnormality group of the BAL center and the normal group compared with the normal group,postoperative carbon dioxide,intraoperative percutaneous oxygen saturation related factors,after the test P<0.05,the difference was statistically significant.6.Multi variate logistic regression analysis showed that the operation time,intraoperative percutaneous oxygen saturation,and no complications were the risk factors for abnormal electrical parameters.(P<0.05 difference was statistically significant).Conclusion:1.BAL has an effect on the ECG index of children with severe pneumonia.The incidence rate is about 1/2.The incidence of I°atrioventricular block and ST-T-wave change is the highest,but most of them are transient.Most of the recovery can be recovered after surgery.2.The younger the child,the longer the operation time,the higher the postoperative carbon dioxide,the lower the percutaneous oxygen saturation during surgery,and the children with complications such as pleural effusion are more prone to abnormal ECG when performing BAL..3.The longer the operation time,the lower the percutaneous oxygen saturation during operation,and no complications were the independent risk factors of abnormal electrical parameters.The operation time was most closely related to the abnormality of the operation center.4.The higher the postoperative carbon dioxide,the lower the intraoperative percutaneous oxygen saturation,and the higher the abnormal incidence rate of the central electrical parameters,all suggesting that the hypoxia in the operation is an independent risk factor for the abnormal electrical index of the child.So Oxygen inhalation in the whole process is necessary,which can benefit to reduce the abnormal incidence rate of BAL surgery center.