外科手术期间的氧化 - - 什么是压力?
Joseph Larvin1,2, Mark Edwards1,2, Daniel S Martin3
1Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK.
BJA open
|March 28, 2024
概括
最佳的外科手术期间的氧气管理是有争议的. 本综述检查了麻醉期间高与低氧水平 (FiO2) 的证据,对比指南及其对患者结果的影响.
科学领域:
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 外科手术的安全性
背景情况:
- 氧是麻醉中最常用的药物.
- 由于高氧和低氧的风险,最优的外科手术期间的氧气水平仍在争论中.
- 目前的指导方针,如世卫组织的0.8 FiO2建议,与一些研究表明潜在的危害相冲突.
研究的目的:
- 审查当前关于外科手术期间氧气管理的证据.
- 为了对比在麻醉中使用氧气与其他专业.
- 探索氧气对外科手术应激反应和患者结果的影响.
主要方法:
- 基于BJA威廉·梅普尔森讲座的叙事综述.
- 对现有的临床试验数据和科克莱恩评论的分析.
- 麻醉氧实践与重症监护医学的比较.
主要成果:
- 关于最优的微分启发氧度 (FiO2) 存在相互矛盾的证据.
- 人们仍然担心高FiO2的潜在增加发病率和死亡率,特别是在某些患者群体中.
- 世卫组织对高FiO2的建议受到争论,一些研究结果被认为是"生物学上不可信的".
结论:
- 对于临床医生来说,解决术后氧气管理中的争议至关重要.
- 需要个性化氧化策略,需要新的临床试验设计.
- 进一步的研究是必要的,以优化患者在外科期间的氧化.
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