早期术后血动力学和实验室参数对Fontan手术后结果的影响
Chiara Di Padua1,2,3, Takuya Osawa1,2,3, Birgit Waschulzik4
1Department of Congenital and Pediatric Heart Surgery, German Heart Center Munich, Technische Universität München, Munich, Germany.
Cardiology in the young
|January 29, 2024
概括
在肺动脉压力,平均动脉压力,氧和和全腔肺连接后的乳酸水平的早期术后监测可以预测不良事件. 这些血液动力学和实验室参数对于识别手术后患并发症风险的患者至关重要.
科学领域:
- 心血管外科心血管外科
- 儿童心脏病学 儿童心脏病学
- 关键护理医学 关键护理医学
背景情况:
- 全腔肺连接 (TCPC) 是一种复杂的Fontan-type程序,用于单心室生理学.
- 早期发现术后并发症对于改善患者的治疗结果至关重要.
研究的目的:
- 确定早期术后血液动力学和实验室指标,预测TCPC后的结果.
- 为了确定这些参数的预测截止值.
主要方法:
- 在2012年至2021年期间,对249名接受TCPC治疗的患者进行了回顾性分析.
- 连续监测肺动脉平均压力,平均动脉压,周围氧和和乳酸水平.
- 接收器操作特征 (ROC) 分析以确定预测截止值.
主要成果:
- 升高的肺动脉压力 (13-17 mmHg) 预测了胸管排水,胸,,以及不良事件.
- 较低的平均动脉压 (<1 mmHg) 与长时间的胸管排水和不良事件有关.
- 在手术后的第一天和第二天,较低的外周氧和较高的乳酸盐水平也与不良结果相关.
结论:
- 早期术后肺动脉压力,平均动脉压力,外周氧和和乳酸水平是TCPC后在医院和出院后不良事件的重要预测因素.
- 这些参数可以指导早期术后期的临床管理和风险分层.
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