术后急性损伤 在手术内低血压后 在重大风险手术中
Patrícia Martins Lima1, Luana Ferreira1, Ana Lídia Dias2,1
1Department of Anesthesiology, Unidade Local de Saúde São João, Porto, PRT.
Cureus
|August 15, 2024
概括
术内低血压 (IOH) 在高风险手术中很常见,但与死亡率或损伤无关. 手术后急性损伤 (PO-AKI) 是30天死亡率的重要风险因素.
科学领域:
- 麻醉学 麻醉学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 外科手术的结果
背景情况:
- 据报道,手术内低血压 (IOH) 是普遍存在的,并与不良结果相关.
- 高风险的非心脏手术对血液动力学管理提出了独特的挑战.
- 了解IOH发生率及其后果对于患者安全至关重要.
研究的目的:
- 为了确定高风险非心脏手术中手术内低血压 (IOH) 的发生率.
- 调查IOH和术后急性损伤 (PO-AKI) 之间的相关性.
- 评估IOH与30天术后死亡率的相关性.
主要方法:
- 对接受高风险非心脏手术的成年住院患者进行回顾性队列研究.
- 根据2022年麻醉质量研究所标准定义的IOH.
- PO-AKI以血清肌素增加或在48小时内需要透析来定义.
主要成果:
- 在研究人群中观察到IOH的高发病率 (56.3%).
- 较长的手术时间 (>120分钟) 和联合麻醉技术是IOH的风险因素.
- 在IOH和30天术后死亡率或PO-AKI之间没有发现显著的关联.
- PO-AKI发病率为14.9%,与30天术后死亡率的增加显著相关.
结论:
- 在高风险的非心脏手术中,术内低血压非常普遍.
- 术后急性损伤,而不是IOH,是30天死亡率的重要预测因素.
- 强调需要PO-AKI查和手术患者的脏保护策略.
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