在心脏手术后对手术室输出管和输出管时间进行了回顾性多中心研究
Eric W Etchill1, Xiaoting Wu2, Diane Alejo1
1Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Md.
心脏手术后的手术室输出管没有提供临床益处,并且与并发症增加有关. 长时间的重症监护室通风,特别是超过22小时,也会增加患者的风险.
科学领域:
- 心脏病学 心脏病学
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
背景情况:
- 目前正在研究术内输出管,以改善心脏手术后的康复.
- 这项研究比较了手术室 (OR) 输出管与早期重症监护室 (ICU) 输出管的结果.
研究的目的:
- 为了评估OR输出管的临床结果与早期ICU输出管在心脏手术患者相比.
- 评估时间到ICU extubation对死亡率和发病率的影响.
主要方法:
- 一项多中心队列研究包括163,982名接受动心脏手术 (2011-2020) 的患者.
- 在OR输出管和早期ICU输出管组之间比较了结果.
- 分析了整体ICU输出管的时间和相关结果.
主要成果:
- 手术室输出管 (2.6%) 与更长的OR时间和更高的再输入管率,延长的通风,对出血和肺炎的重新手术有关.
- 在OR抽管组 (OR,1.34) 中,住院死亡率更高.
- 术后ICU通风22小时以后,死亡风险显著增加.
结论:
- 心脏手术后的手术室输出管与临床益处无关,并且增加了发病率.
- 心脏手术计划应该重新评估OR输出管术心肺绕道术后的实践.
- 延长输管时间 (>22小时) 与增加不良结果有关.
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