鱼油脂肪乳联合肠外营养支持对先天性心脏病术后机械通气患儿血气指标及呼吸力学的影响OA北大核心CSTPCD

Objective To explore the effects of fish oil fat emulsion combined with parenteral nutrition support on blood gas parameters and respiratory mechanics in children with congenital heart disease after me-chanical ventilation post-surgery.Methods A retrospective analysis was conducted on the clinical data of 50 children with congenital heart disease who underwent mechanical ventilation in the Intensive Care Department of Quanzhou Children's Hospital from January 2020 to October 2023.The patients were randomly divided into a study group and a control group using a double-blind method,with 25 cases in each group.The control group re-ceived parenteral nutrition support 48 hours after intensive care unit(ICU)admission.The study group received parenteral nutrition support combined with fish oil fat emulsion 48 hours after ICU admission.The intervention effects,including nutritional indicators,inflammatory factors,blood gas parameters,and respiratory mechanics,were evaluated after 7 days.Results After the intervention,the study group showed significant increases in se-rum albumin(ALB)[(41.43±4.26)g/L vs.(36.85±3.82)g/L],prealbumin(PA)[(182.32±21.24)mg/L vs.(153.37±18.65)mg/L],and transferrin(TRF)[(2.62±0.57)g/L vs.(2.18±0.48)g/L]compared to before the intervention(P＜0.05),with statistically significant differences(P＜0.05).Blood gas parameters showed that the partial pressure of oxygen(PaO2)[(81.33±6.26)mmHg vs.(72.85±8.15)mmHg],oxygenation index[(258.87±35.12)vs.(223.54±31.65)],and diffusion index[(244.37±36.32)vs.(213.64±28.85)]increased in the study group compared to before the intervention,while the par-tial pressure of carbon dioxide in arterial blood(PaC02)[(43.46±4.25)mmHg vs.(48.87±5.32)mm-Hg]and lactate(Lac)[(1.35±0.22)mmol/L vs.(92.12±0.27)mmol/L]decreased.The study group had higher PaO2,oxygenation index,and diffusion index,and lower PaC02 and Lac compared to the control group,with statistically significant differences(P＜0.05).In terms of cytokines,interleukin(IL)-1β[(11.26±3.53)pg/ml vs.(16.65±3.85)pg/ml],IL-6[(52.54±8.45)pg/ml vs.(73.32±9.37)pg/ml],and tumor necrosis factor(TNF)-α[(6.35±1.14)μg/L vs.(9.32±1.85)pg/L]decreased in the study group compared to before the intervention,and were lower than the control group(P＜0.05),with statistically signifi-cant differences(P＜0.05).Respiratory mechanics showed that inhalation resistance(Raw)[(8.26±2.35)cmH2O/L·s vs.(11.24±2.87)cmH20/L·s]decreased and lung compliance(CL)[(35.37±5.22)mL/cmH20 vs.(30.82±4.83)mL/cmH20]increased in the study group compared to before the intervention,with lower Raw and higher CL than the control group,and statistically significant differences(P＜0.05).Conclu-sions The combination of fish oil fat emulsion and parenteral nutrition support in children with congenital heart disease after mechanical ventilation can improve nutritional status,reduce the expression of inflammatory fac-tors,promote the recovery of blood gas parameters,and thus improve respiratory mechanics.