机械通风模式类型对心脏手术后术后肺部并发症的影响:一项随机对照试验
Xue-Fei Li1, Wen-Jie Mao2, Rong-Juan Jiang3
1Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China.
Journal of cardiothoracic and vascular anesthesia
|December 17, 2023
概括
术内通风模式不会影响心肺绕道心脏手术后的肺部并发症. 这项研究发现,体积控制通风和压力控制通风模式之间的结果没有显著差异.
科学领域:
- 麻醉学和重症监护医学
- 胸部外科手术 胸部外科手术
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 最佳的手术内通风策略对于接受心肺旁路 (CPB) 心脏手术的患者至关重要.
- 不同的通风模式对这一群体的术后肺部并发症 (PPC) 的影响仍然不清楚.
研究的目的:
- 调查特定的手术内通风模式是否改善了CPB进行心脏手术的成年患者的肺部结果.
- 为了比较PPCs在体积控制通风 (VCV),压力控制通风 (PCV) 和压力控制通风-体积保证 (PCV-VG) 模式中的发生率.
主要方法:
- 一个单中心,前性,随机对照试验,涉及1364名接受CPB心脏手术的成年患者.
- 参与者被随机分配到VCV,PCV或PCV-VG,所有这些都使用肺保护性通风策略.
- 主要结局是手术后前7天内PPC的复合物.
主要成果:
- PPC的发生率为PCV-VG的36.9%,PCV的37.6%,VCV的40.1%.
- 在三个通风组 (p=0.585) 中,没有观察到肺部并发症的总体风险的统计学上显著差异.
- 在PPC严重程度,通风持续时间,ICU停留,住院或30天死亡率方面没有发现显著差异.
结论:
- 在手术内呼吸模式的选择似乎不会影响手术后肺部并发症的风险,在接受心脏手术的患者中,CPB.
- 当前的肺防护通风策略可以在这种外科背景下减轻通风模式之间的差异.
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