在门诊外科手术中心的手术内低血压
Wael Saasouh1, Anna L Christensen2, Desirée Chappell3
1Detroit Medical Center, Department of Anesthesiology, 3990 John R, Office 2941, Detroit, MI 48201, USA; NorthStar Anesthesia, 6225 State Hwy 161 #200, Irving, TX 75038, USA; Outcomes Research Consortium, The Cleveland Clinic, 9500 Euclid Ave -- P77, Cleveland, OH 44195, USA.
Journal of clinical anesthesia
|July 16, 2023
概括
术内低血压 (IOH) 发生在30.9%的门诊外科手术中心病例中. 这项研究强调了ASC的IOH发病率和患者因素,促使进一步研究不良结果.
科学领域:
- 麻醉学 麻醉学
- 外科手术的结果
- 医疗保健服务研究 医疗服务研究
背景情况:
- 术内低血压 (IOH) 是外科手术过程中的一个关键问题.
- 了解在门诊外科中心 (ASC) 的IOH发病率对于患者安全至关重要.
- 以前的文献主要集中在医院环境中的IOH.
研究的目的:
- 测量在门诊手术中心 (ASC) 内手术性低血压 (IOH) 的发生率.
- 描述与ASC中IOH相关的患者和程序特征.
- 将ASC中的IOH发病率与学术医院设置的发现进行比较.
主要方法:
- 在20个ASC进行非急性非心脏手术的16,750名患者的回顾性分析.
- 根据CMS MIPS标准,IOH被定义为平均动脉压 (MAP) <65 mmHg至少累计15分钟.
- 二次定义包括MAP <65 mmHg的分钟,MAP <65 mmHg的面积和时间加权的平均MAP <65 mmHg.
主要成果:
- 30.9%的病例经历了IOH (MAP <65 mmHg超过15分钟).
- 在年轻的成年人 (18-39岁;36.2%),女性 (35.2%) 和ASA身体状况2患者 (32.8%) 中观察到较高的IOH发病率.
- 随着手术长度的增加,IOH增加,在高度复杂的手术中最高 (44.1%).
结论:
- 在ASC中发现了大量IOH的发生,与医院环境相似.
- 假设表明潜在的临床医生缺乏干预或对患者耐受性的假设.
- 需要进一步的研究来确定ASC中的IOH是否与类似于医院手术的不良结果有关.
相关概念视频
01:26Cardiac Catheterization IV: Nursing Management
68
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
68
01:23Peripheral 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
01:28Cardiomyopathy 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
01:28Cardiac Catheterization I: Pre-Procedure Overview
69
Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
69
01:22Aneurysm 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
01:30Alterations in Blood Pressure
1.3K
Alterations in blood pressure, such as hypertension (high blood pressure) and hypotension (low blood pressure), significantly affect human health. Understanding these conditions' classifications, causes, and symptoms is essential for effective management and treatment.
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart...
Hypertension (High blood pressure)
Hypertension occurs when blood pressure readings consistently exceed the normal range. It is diagnosed when systolic blood pressure (the top number, indicating pressure while the heart...
1.3K