低剂量上腺素与目标导向液体治疗相结合对肺外科手术中术后肺部并发症的作用:一项前性随机对照试验
1Department of Anesthesiology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province 230022, China.
Journal of clinical anesthesia
|October 10, 2024
概括
与目标导向液体疗法 (GDFT) 连续使用低剂量的诺阿皮内弗林,与标准护理相比,在肺部手术患者中减少了术后肺部并发症 (PPC). 然而,它与单独使用GDFT没有显著差异.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 关键护理医学 关键护理医学
背景情况:
- 手术后的肺部并发症 (PPC) 是肺部手术后的一个主要问题.
- 术内流体治疗显著影响PPCs的发生.
- 优化流体管理对于改善胸部手术后患者的治疗结果至关重要.
研究的目的:
- 评估连续低剂量上腺素输注与目标导向液体疗法 (GDFT) 结合在肺部手术后减少PPC的疗效.
- 为了比较这种结合方法与单独的GDFT和标准流体处理.
- 评估对血液动力学稳定性和其他术后结果的影响.
主要方法:
- 一项前性随机对照试验,涉及184名接受选择性胸腔镜肺切除的患者.
- 患者被分配到三个组:标准的液体治疗 (C组),GDFT (G组) 和持续的低剂量诺亚上腺素与GDFT (N组).
- 主要结局是PPC的发生率;次要结局包括血液动力学变量和其他并发症.
主要成果:
- 与C组相比,N组的PPC发病率明显较低 (11.5%对27.9%,P=0.023).
- 在N组和G组之间没有观察到PPC的显著差异 (11.5%对14.5%,P=0.616).
- 与C组相比,N组表现出改善的手术内平均动脉压和中风体积指数.
结论:
- 与GDFT相结合的连续低剂量的诺阿基尼林有效地减少了肺部手术患者的PPC,而不是标准的流体管理.
- 这种联合策略在预防PPC方面并没有比单独的GDFT提供额外的好处.
- 这些发现表明,上腺素在胸部手术期间优化流体管理方面可能发挥作用.
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