手术部位感染和在一般手术患者群体中常规使用术后高氧症:随机对照试验
Kane O Pryor1, Thomas J Fahey, Cynthia A Lien
1Department of Anesthesiology, Weill Medical College of Cornell University, New York, NY 10021, USA. kopryor@yahoo.com
JAMA
|January 8, 2004
概括
在手术期间的常规高氧水平不会减少手术部位感染 (SSIs),而且可能会增加它们的发生. 根据患者生理学指导的标准氧气治疗是一般手术患者的建议,以预防SSI.
科学领域:
- 麻醉学 麻醉学
- 手术瘤学手术瘤学
- 关键护理医学 关键护理医学
背景情况:
- 手术部位感染 (SSI) 是整体外科的一个主要问题.
- 高分量启发氧 (FIO2) 在特定的患者群体中显示出潜在的益处,但其常规使用尚未建立.
研究的目的:
- 调查在外科手术期间常规高FIO2给药是否会影响一般手术患者的SSI发病率.
主要方法:
- 进行了一项双盲随机对照试验,其中165名患者接受了重大腹内外科手术.
- 在手术期间和手术后2小时内,患者接受了80%的氧气 (FIO2 0.80) 或35%的氧气 (FIO2 0.35).
- 通过临床评估,管理变化和特定标准来定义,SSI在14天内进行评估.
主要成果:
- 在高FIO2组 (25.0%) 中,SSI的发病率明显高于标准组 (11.3%;P =.02).
- 高FIO2 (0.80) 被确定为SSI的重要预测因子.
- 患有SSI的患者在医院住院时间较长 (13.3天 vs 6.0天;P<.001).
结论:
- 常规高的外科手术期间FIO2不会降低一般外科手术中的SSI率,并且可能是有害的.
- 在一般的外科手术患者中,氧气的使用应优先考虑心肺呼吸系统生理学.
相关概念视频
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