进行冠状动脉旁路移植的患者的睡眠呼吸暂停:对术后结果的影响
Kassar Farha1, Mustafa Gercek2, Muhammed Gercek3
1Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany.
Journal of sleep research
|February 27, 2024
概括
心脏手术患者的睡眠呼吸障碍是常见的,并且与更糟糕的结果有关. 严重的病例与更长的通风和感染风险相关,突出显示了手术前查的必要性.
科学领域:
- 心脏病学 心脏病学
- 睡眠医学 睡眠医学
- 关键护理医学 关键护理医学
背景情况:
- 睡眠呼吸障碍 (SDB) 在接受冠状动脉旁路移植 (CABG) 的冠状动脉疾病 (CAD) 患者中很普遍.
- SDB与术后发病率增加有关,包括心房动等心律失常,以及死亡率.
- 在CABG后,SDB对术后结果的影响需要进一步调查.
研究的目的:
- 调查SDB对CABG后术后过程的影响.
- 确定SDB和CABG后新发性心房动之间的关联.
- 确定SDB作为不良术后事件的预测因素.
主要方法:
- 对接受CABG的成年人进行前性单中心队列研究.
- 在符合条件的患者中进行SDB (多重检测) 和心房动 (ECG) 的术前查.
- 回归分析以评估SDB严重程度和结果之间的关联:新发动的心房动,通风持续时间,ICU停留时间和感染.
主要成果:
- 在508名参与者中,SDB的患病率为52.9% (呼吸暂停-呼吸暂停指数≥5/小时).
- 严重的SDB (AHI>30/hr) 与更长的机械通风 (OR 5.28) 和更高的感染率 (OR 3.32) 相关.
- 没有发现SDB和新发性心房动或死亡率之间有显著的关联;然而,心房动与感染和长时间停留有关.
结论:
- 严重的SDB是CABG后长时间通风和术后感染的重要危险因素.
- 在接受心脏手术的患者中,对SDB进行手术前查是有必要的.
- 虽然SDB在这项研究中没有预测新发性AFib,但AFib仍然是与感染有关的关键术后并发症.
相关概念视频
Sleep Apnea
156
Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...
The condition is more prevalent among...
156
General Anesthesia: Overview
219
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
219
Insufficient Sleep and Sleep Deprivation
143
Insufficient sleep refers to not getting the recommended amount of sleep for optimal functioning, even if it's just slightly less than needed. Sleep insufficiency may occur due to lifestyle choices, such as staying up late for social events or work, resulting in routinely getting less sleep than required. For example, consistently sleeping 6 hours when the body needs 7-9 hours can lead to cumulative effects on health and well-being.
Sleep deprivation is a more severe form of sleep loss...
Sleep deprivation is a more severe form of sleep loss...
143
Substance Use Disorders Affecting Sleep
167
Substance use disorders involve a pattern of using drugs more extensively than intended and continuing use despite harmful consequences. This includes legal substances like alcohol and nicotine, as well as illegal drugs. These disorders often involve both physical and psychological dependence, reflecting compulsive use of substances that significantly alter thoughts, feelings, and behaviors, contributing to a major public health issue.
Understanding the concepts of physical dependence,...
Understanding the concepts of physical dependence,...
167
Respiratory Assessment: Purpose and Indications
1.1K
Respiratory assessment is a cornerstone of nursing assessments, crucial for the early detection of patient deterioration. This evaluation transcends routine procedures, representing a critical skill nurses must master to ensure optimal patient care.
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
1.1K
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
84
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
84


