术内心肺绕道功率与心脏手术后的并发症之间的关联
Victor Hui1,2, Kwok M Ho3,4, Rebecca Hahn2
1Department of Anaesthesia and Pain Medicine, Royal Melbourne Hospital, Melbourne, VIC, Australia.
Perfusion
|July 13, 2023
概括
心脏外科手术中的心脏功率和心肺绕道过程中的流量与心脏手术中的不良事件无关. 然而,绕道术期间的低平均动脉压 (MAP) 是这些患者脏问题的独立风险因素.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 低心力功率与心肌梗塞后心脏病性休克死亡率有关.
- 心脏功率以前没有在心脏手术患者中进行过研究.
- 假设:心肺绕道术期间的心脏功率与不良事件的相关性比单独的流量或平均动脉压 (MAP) 更大.
研究的目的:
- 调查心脏功率,流量和心肺旁路术期间MAP之间的关联以及心脏手术患者的不良事件.
- 为了确定心脏功率是否比单独的流量或MAP更好地预测不良结果.
主要方法:
- 1984年心脏手术的回顾性观察研究 (2015年2月 - 2022年3月).
- 排除标准:年龄小于18岁,胸部移植,VADs,离手术,大动脉手术.
- 主要结局:30天死亡率,中风或新发功能不全的组合.
主要成果:
- 没有发现持续时间或心脏功率,MAP或流量值以下的区域与初级复合结果之间的联系.
- 低于MAP值 (35-50 mmHg) 的区域与新的功能不全有关 (aOR 1.17 [95% CI 1.02-1.35]).
结论:
- 心肺绕道期间的平均动脉压 (MAP),而不是心脏功率或流量,是心脏手术患者脏不良结果的独立风险因素.
相关概念视频
Cardiomyopathy VII: Pre and Post Operative Nursing Management
16
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
16
Peripheral Artery Disease V: Postoperative Nursing Management
12
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
12
Cardiac Catheterization II: Right Heart Catheterization
55
Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
55
Pathophysiology of Cardiac Performance
708
Typical heart performance is influenced by heart rate, rhythm, myocardial contraction, and metabolism or blood flow. The cardiac muscle exhibits distinct electrophysiological features, including pacemaker activity and calcium channel control, which play a vital role in the heart's response to various drugs. The autonomic nervous system, comprising the sympathetic and parasympathetic branches, regulates heart rate. Sympathetic activation increases heart rate, while parasympathetic activation...
708
Aneurysm IV: Nursing Management
8
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
8
Imbalances in Cardiac Output
1.4K
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.4K


