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在隔离冠状动脉绕道术后在手术室进行例行输出管
Les James1, Deane E Smith1, Aubrey C Galloway1
1Department of Cardiothoracic Surgery, NYU Langone Health, New York, New York.
The Annals of thoracic surgery
|October 8, 2023
概括
在非紧急冠状动脉旁路移植 (CABG) 后在手术室 (OR) 输出患者的输出是安全的和可行的. 这种策略可以减少重症监护室 (ICU) 的时间和住院时间,而不会增加并发症.
科学领域:
- 心胸外科手术 心胸外科手术
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
背景情况:
- 心脏手术后在重症监护室 (ICU) 进行快速输出管是有益的.
- 在手术室 (OR) 中的输出管对于某些患者来说是安全的,但其在心脏外科手术中的广泛使用尚未确立.
- 这项研究评估了OR与ICU输出管的术后结果,用于非紧急的隔离冠状动脉旁路移植 (CABG).
研究的目的:
- 为了比较在手术室 (OR) 和重症监护室 (ICU) 间的术后结果,在接受非紧急隔离冠状动脉旁路移植 (CABG) 的患者中进行输出管.
- 评估常规OR输出管的可行性和安全性,用于接受CABG的更广泛的患者群体.
主要方法:
- 胸腔外科医生协会 (STS) 对6年 (2017-2022) 期间接受非紧急隔离CABG的单一中心患者数据的分析.
- 在ICU和OR输出组之间的术后发病率和死亡率的比较.
- 倾向性得分匹配被用来创建可比的队列进行分析.
主要成果:
- 在倾向匹配的队列 (414对) 中,在OR和ICU输出组之间,在重新输入,为出血重新进行手术,手术时间,中风,功能衰竭或30天死亡率方面没有发现显著差异.
- 手术室 (OR) 输出与更短的ICU小时 (14 vs. 20小时),减少术后住院时间 (3 vs. 5天),更高的直接到家出院率 (97.3% vs. 89.9%) 和更低的30天再入院率 (1.7% vs. 4.1%) 相关.
- 这些结果在统计学上是显著的 (大多数情况下P < .0001,再接收时P = .04).
结论:
- 在手术室 (OR) 进行常规的输出管是非紧急冠状动脉旁路移植 (CABG) 后广泛患者的安全和可行的策略.
- 这种方法不会增加外科手术期间的发病率或死亡率.
- 建议在非紧急情况下采用更广泛的常规OR输出管用于CABG.
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