转移期间的高血压与不稳定患者的不良结果有关,这些患者有腹腔大动脉动脉瘤破裂
Shimena R Li1, Amanda R Phillips2, Katherine M Reitz3
1Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
Journal of vascular surgery
|December 1, 2023
概括
腹腔大动脉动脉瘤破裂 (rAAA) 患者在休克期间的高血压和严重低血压与更高的30天死亡率有关. 维持静脉压在70mmHg以上至关重要.
科学领域:
- 心血管外科心血管外科
- 创伤外科 手术 创伤外科
- 关键护理医学 关键护理医学
背景情况:
- 在破裂腹腔大动脉动脉瘤 (rAAA) 患者在出血性休克期间的医院间转移期间,最佳的血压 (BP) 管理仍然不清楚.
- 了解运输期间血压波动的影响对于改善rAAA患者的治疗结果至关重要.
研究的目的:
- 评估高血压和严重低血压对rAAA患者在医院间转移期间经历出血性休克的30天死亡率的影响.
- 在rAAA患者的紧急运输过程中确定最佳的BP管理策略.
主要方法:
- 在2003-2019年间通过空中救护车转移的271名rAAA患者的回顾性评估.
- 分析集中在125名患有出血性休克的患者身上,根据转移期间的高血压 (静态血压≥140毫米升) 和严重低血压 (静态血压<70毫米升) 情节的结果进行了比较.
- 主要结局是30天死亡率,使用多变量逻辑回归来评估.
主要成果:
- 26.4%的休克患者患有高血压,46%的患者在转移期间患有严重的低血压.
- 转移期间的高血压与30天死亡率增加4.71倍相关 (aOR,4.71;P=.007).
- 严重的低血压与30天死亡率增加2.82倍相关 (aOR,2.82;P=.01).
结论:
- 医院间转移期间的高血压和严重低血压发作都独立地增加了rAAA患者的30天死亡率.
- 建议在转移期间避免高血压和维持静脉血压超过70mm Hg,以改善这一关键患者群体的存活率.
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