心肺旁路术期间的动脉高氧化与术后肺功能恶化无关:一项回顾性队列研究
Marta Kelava1,2, Adam J Milam3, Junhui Mi4
1From the Departments of Cardiothoracic Anesthesiology.
Anesthesia and analgesia
|September 21, 2023
概括
这项研究发现,心脏手术期间的动脉氧气水平与肺损伤之间没有显著的联系. 在心肺旁路术期间氧气水平较高并没有使术后肺功能或器官损伤恶化.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 关键护理医学 关键护理医学
背景情况:
- 心肺绕道 (CPB) 期间的动脉过氧可能会增加自由氧基的形成,可能导致末端器官损伤.
- 临床证据对手术后的肺毒性,因为在CPB期间的高氧化,是有限的,其对肺损伤的影响是研究不足的.
- 这项研究调查了心脏手术和肺损伤期间的动脉部分氧气压 (PaO2) 与肺损伤之间的关系.
研究的目的:
- 为了检查PaO2在CPB期间与术后肺损伤之间的联系.
- 其次,评估PaO2与全球和区域组织阻 perfusion的标志物之间的关系,包括乳酸和急性损伤.
- 探索与心脏和肝损伤标志物的关联.
主要方法:
- 对接受CPB选择性心脏手术的患者进行回顾性队列研究 (2015年4月 - 2021年12月).
- 主要结局:手术后的肺功能 (PaO2/FiO2比率) 手术后6小时或输出之前.
- 使用线性或逻辑回归分析,根据基线混因素进行调整.
主要成果:
- 总共有8429名患者被纳入分析.
- 在CPB期间的时间加权平均PaO2与术后P/F比率之间观察到微弱的正相关性 (每增加100个PaO2单位增加4.61,P=.02).
- 在CPB期间的PaO2与峰值/平均乳酸水平或急性损伤 (KDIGO标准) 之间没有发现显著的关联.
结论:
- 在CPB期间的PaO2与术后肺功能之间没有发现临床显著的关联.
- 在CPB期间的动脉氧气水平与乳酸水平,功能或其他被探索的器官损伤标志物无关.
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