在接受心脏手术的患者中,术后狂妄症的风险因素是术后血压变化
Xiao Shen1, Hong Tao1, Wenxiu Chen1
1Department of Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, 210006, Nanjing, People's Republic of China.
BMC anesthesiology
|November 24, 2024
概括
心脏手术后的术后妄 (POD) 与血压变化 (BPV) 有关. 血压的平均真实变化 (ARV) 较高,特别是在手术后,会增加POD的风险. 保持稳定的血压可以防止妄想.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 密集护理医学 密集护理医学
背景情况:
- 妄想是心脏手术后经常出现的神经并发症.
- 了解术后痴呆症 (POD) 的危险因素对于患者的治疗结果至关重要.
- 外科手术期间血压变化 (BPV) 是POD发展的一个潜在的,研究不足的因素.
研究的目的:
- 为了研究术前血压变化 (BPV) 和术后妄 (POD) 之间的关联.
- 确定与心脏外科手术患者POD发病率相关的特定BPV指标.
主要方法:
- 研究了接受心血管重症监护室 (ICU) 的成人心脏手术患者.
- 术后血压变化 (BPV) 用标准偏差 (SD) 和实际平均变化 (ARV) 来量化.
- 妄想评估使用精神状态评估和混乱评估方法 (CAM).
- 进行了LASSO和后勤回归分析,以确定BPV和POD之间的关系.
主要成果:
- POD的发病率为15.0%,平均发病时间在术后第3天.
- 患有POD的患者表现出较低的手术内平均血压和血压ARV.
- 然而,患有POD的患者在术后24小时内表现出显著更高的静脉压,静脉压和平均血压的ARV.
- 在手术期间的血压ARV,中央静脉压的平均值和手术后的静脉血压ARV被确定为POD的独立风险因素.
结论:
- 外科手术期间的平均真实变化 (ARV),特别是手术后的ARV升高,与术后妄想 (POD) 有关.
- 在外科手术期间保持稳定的血压可能是减少心脏手术患者POD发病率的一种策略.
相关概念视频
01:17Measurement of Blood Pressure
872
Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a...
872
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
522
Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the...
522
01:28Special considerations while measuring blood pressure
705
When assessing blood pressure (BP), healthcare professionals must consider various factors and potential unexpected outcomes to ensure accurate readings and provide proper patient care. Adhering to these guidelines is essential to achieving the most reliable results.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
705
01:25Errors occurring during blood pressure monitoring
604
Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
Several factors...
604
01:19Assessing Blood pressure using a doppler ultrasound
1.2K
To obtain accurate blood pressure measurements in clinical settings, especially when traditional methods are insufficient, healthcare professionals utilize the Doppler ultrasound technique. This method uses high-frequency sound waves to detect blood flow within the arteries, which is crucial for patients with conditions that complicate circulatory system assessment.
Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
Preparation of Equipment:
Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
Preparation of Equipment:
1.2K
01:23Assessment of blood pressure in brachial artery(two-step method)
656
Measuring blood pressure is a fundamental skill in healthcare that aids in diagnosing and monitoring hypertension and other cardiovascular conditions. An aneroid sphygmomanometer, commonly used in clinical settings, offers a manual and precise method for blood pressure measurement. The technique for using this instrument involves specific steps that must be carefully executed to ensure accuracy. The following detailed description outlines a two-step technique for assessing blood pressure using...
656