非侵入性通风可减少腹部外科手术患者的术后呼吸衰竭:回顾性分析
Francesco Imperatore1, Fabrizio Gritti2,3, Rossella Esposito2,3
1Unit of Anaesthesia and Intensive Care, "San Giovanni di Dio Hospital" Frattamaggiore, 80020 Naples, Italy.
Medicina (Kaunas, Lithuania)
|August 26, 2023
概括
手术后的非侵入性通风 (NIV) 改善了肥胖患者的肺功能和氧气供应在减肥手术后. 这减少了急性呼吸衰竭和急性护理需求,使NIV成为一种有价值的策略.
科学领域:
- 麻醉学 麻醉学
- 肺部病理学 肺部病理学
- 腹部外科 腹部外科
背景情况:
- 肥胖 (高BMI) 与肺体积和肺容量减少有关.
- 在接受麻醉的肥胖患者中,术后急性呼吸衰竭 (ARF) 是一个重大问题.
- 非侵入性通风 (NIV) 是减轻这些风险的潜在策略.
研究的目的:
- 评估术后NIV在麻醉后护理单位 (PACU) 的疗效.
- 评估NIV对减轻肥胖患者在胆肠道旁路 (BIBP) 后的ARF的影响.
主要方法:
- 在2019年1月至2020年12月接受BIBP的肥胖患者的回顾性分析.
- 患者接受术后NIV与常规Venturi口罩的比较.
- 在72小时内评估ARF和PACU中的氧度值.
主要成果:
- 在PACU中120分钟后,NIV组显示出明显更好的pH,pCO2,pO2和SpO2 (p<0.001).
- 在72小时内,ARF发生在2%的NIV组和12.2%的对照组中.
- 传统的Venturi口罩使用与术后ARF显著相关 (p <0.05).
结论:
- 在PACU中的短期术后NIV可以提高肥胖患者的肺功能和氧化恢复.
- NIV减少了在减肥手术后需要重症监护的需要.
- NIV可能是必要的干预措施,特别是随着白天病例减肥手术的兴起.
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