作为手术后并发症的预后因素的呼吸器效率在接受选择性大手术的患者:一个系统性审查
Thomas Vetsch1, Sabrina Eggmann2, François Jardot3
1Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Centre for Rehabilitation & Sports Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Bern, Switzerland.
British journal of anaesthesia
|April 21, 2024
概括
呼吸系统效率 (VE/VCO2) 预测大手术后的短期并发症. 需要更多的研究来指导使用这种预后因素的临床决策.
科学领域:
- 进行心肺运动测试.
- 手术风险分层的分层化
- 预测因素分析预测因素分析
背景情况:
- 大型手术会带来很大的术后并发症风险.
- 现有的风险评分在个人患者评估中缺乏准确性.
- 呼吸机效率 (VE/VCO2) 是一个潜在的新预后因素.
研究的目的:
- 系统地审查关于VE/VCO2作为术后并发症预后因素的证据.
- 评估 VE/VCO2 在大手术后预测结果中的实用性.
主要方法:
- 在没有研究类型,语言或出版年限的情况下进行全面的文献搜索.
- 两个独立的审查员评估了研究资格和偏差风险.
- 提取了VE/VCO2与术后结果之间的调整和未调整的关联.
主要成果:
- 从10,082个选的记录中,包括了65项研究.
- 在胸部和腹部手术中,VE/VCO2对短期并发症具有预后价值.
- VE/VCO2还预测了中长期死亡率,尽管在混和统计分析中注意到了偏差风险.
结论:
- VE/VCO2被确定为胸部和腹部手术后短期并发症的预测因素.
- 目前的数据不足以对VE/VCO2进行临床决策.
- 未来的研究应该优先选择基于外部知识的共变量.
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