流体治疗和腹部手术中的肺部并发症:随机对照试验
Gabriel Isaac Pereira de Castro1, Renata Sayuri Ansai Pereira de Castro2, Rodrigo Moreira E Lima3
1Universidade Estadual Paulista (UNESP), Faculdade de Medicina de Botucatu (FMB), Botucatu, SP, Brazil.
Brazilian journal of anesthesiology (Elsevier)
|March 30, 2024
概括
与标准护理相比,目标导向流体疗法 (GDFT) 在开放腹部手术患者中显著降低了术后肺部并发症 (PPC). 虽然PPC率下降,但GDFT没有影响死亡率或住院时间.
科学领域:
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 外科手术的结果
背景情况:
- 手术后肺部并发症 (PPC) 在重大手术中构成重大风险.
- 对减少PPC的最佳策略仍在讨论中.
- 这项研究研究了针对标准护理 (SOC) 的目标定向流体治疗 (GDFT).
研究的目的:
- 评估GDFT协议在减少PPCs方面的有效性.
- 在选择性开放腹部手术患者中,将GDFT与SOC进行比较.
- 评估对死亡率和住院时间 (LOHS) 的影响.
主要方法:
- 随机,前性,受控试验 (2012年5月至2014年12月).随机,前性,受控试验 (2012年5月至2014年12月).
- 包括:在全身麻醉下接受开放腹部手术 (>120分钟) 的ASA I-III患者.
- 干预:GDFT协议 (基于BP和PP变化的球体输液) 与SOC (麻醉师的裁量权).
主要成果:
- GDFT组 (43名患者) 显示PPC发生率 (14%) 与SOC组 (42名患者,45%) 相比显著降低 (p=0.003).
- 两组之间死亡率或LOHS没有显著差异.
- PPC患者的死亡率较高 (25%vs. 3%) 和较长的LOHS (14.5vs. 9天).
结论:
- 在选择性开放腹部手术中,GDFT协议有效降低了PPC率.
- GDFT没有证明LOHS或死亡率有所降低.
- 进一步的研究可能会探索优化GDFT以全面改善结果.
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