在冠状动脉疾病的麻醉患者中,高氧诱导的扩张功能恶化 - 随机交叉试验
Jan O Friess1,2, Jan Mikasi1, Rico Baumann1
1Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
BJA open
|August 17, 2023
概括
在手术期间,高氧水平 (过氧) 在冠状动脉疾病患者中恶化了透析功能. 根据基线腹腔功能,对过氧的收缩功能反应有所不同,这表明需要个性化氧气定位.
科学领域:
- 心脏病学 心脏病学
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
背景情况:
- 目前的指导方针缺乏在稳定的冠状动脉疾病 (CAD) 中对氧量定位的建议.
- 在全身麻醉下的CAD患者中,Iatrogenic过氧对心脏功能的影响尚不清楚.
研究的目的:
- 为了研究高氧化对冠状动脉疾病患者在全身麻醉中心脏功能的影响.
- 为了确定氧气定位策略是否可以通过手术内应变分析来指导.
主要方法:
- 一个随机交叉试验,涉及接受冠状动脉旁路移植手术的患者.
- 患者被随机排序暴露于诺莫克西亚 (30%氧) 和高氧 (80%氧).
- 经食道心声学被用来评估3D峰值应变 (心功能) 和心功能参数.
主要成果:
- 在整体缩功能中,normoxia和hyperoxia之间没有显著的差异.
- 对过氧的系统功能反应取决于基线心室功能 (左和右心室全球纵向应变).
- 在高氧化时,扩张功能持续恶化,由增加的E/e'和E/A比率表明.
结论:
- 在CAD患者的高氧化下,透析功能恶化.
- 过氧对心功能的影响是可变的,并且取决于患者的基线心脏功能.
- 术内应变分析可以指导个人化氧气定位在CAD患者.
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