氧气储备指数与单肺通风期间的动脉部分氧气压力之间的关联:一项回顾性队列研究
Yu Jeong Bang1, Youjin Seong1, Heejoon Jeong2
1Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwonro, Gangnamgu, 06351, Seoul, South Korea.
氧气储备指数 (ORi) 有效地反映了胸部手术中单肺通风期间的动脉氧化 (PaO2). 较低的ORI值表明氧化不足的风险更高.
科学领域:
- 麻醉学 麻醉学
- 呼吸系统生理学 呼吸系统生理学
- 手术监测 手术监测
背景情况:
- 一个肺通风 (OLV) 对于胸部手术至关重要,但可能会损害气体交换.
- 监测动脉氧化,特别是氧气的部分压力 (PaO2),在OLV期间至关重要.
- 氧储量指数 (ORi) 是氧化量的非侵入性监测器,但在OLV期间它的实用性需要研究.
研究的目的:
- 为了确定氧气储备指数 (ORi) 与一肺通风期间的动脉部分氧气压 (PaO2) 之间的关联.
- 在非心脏胸部手术中,在单肺通风过程中识别氧化不足 (PaO2 < 150 mmHg) 的风险因素.
主要方法:
- 对554名接受选择性非心脏胸部手术的成年患者进行了回顾性分析,这些患者需要用一个肺进行呼吸.
- 在开始单肺通风15分钟后,同时测量ORI和PaO2.
- 线性回归和后勤回归分析以评估关联并确定风险因素.
主要成果:
- ORi与PaO2有显著的关联 (r2 = 0.5752,P < 0.001). 这表明ORi与PaO2有显著的关联 (r2 = 0.5752,P < 0.001).
- 0.27的ORI值有效区分了PaO2≥150mmHg,具有高灵敏度 (0.909) 和特异性 (0.932).
- 较低的ORI,年龄较大,BMI较高,左侧的OLV和较低的血红蛋白是PaO2<150mmHg的危险因素.
结论:
- 氧储量指数 (ORi) 为非心脏胸部手术中单肺通风期间的动脉氧化提供了宝贵的见解.
- 在此过程中,ORI可以帮助识别患有低氧血症风险的患者.
- 在胸部手术期间,ORI监测可能有助于优化氧化管理.
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