在手术前的心肺运动测试中,不同的呼吸效率测量对于预测腹部癌症手术中的术后并发症是有用的
Elin Stark1, Edvard Gerring2, Johan Hylander3
1Department of Anaesthesiology and Intensive Care, Centre for Clinical Research, Sörmland, Nyköping Hospital, Nyköping, Sweden.
Acta anaesthesiologica Scandinavica
|December 11, 2024
概括
手术前的潮尾二氧化碳 (PetCO2) 的部分压力和通风/ perfusion 斜率 (VE/ VCO2) 有效地预测大腹部手术后的并发症. PetCO2 提供与 VE/VCO2 斜率相似的预测实用性,并且可能更容易获得.
科学领域:
- 进行心肺运动测试.
- 手术风险分层的分层化
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- VE/VCO2斜率是已知的术后并发症的预测指标.
- 关于PetCO2在重大腹部手术中风险分层的有用性,研究有限.
- 无论是VE/VCO2倾斜率还是PetCO2都受到通风/ perfusion 不匹配的影响.
研究的目的:
- 确定手术前的VE/VCO2斜率与PetCO2.2之间的相关性.
- 评估这些措施与主要心肺并发症 (MCPCs) 或主要腹部癌症手术后死亡的关联.
主要方法:
- 对116名接受手术前CPET治疗的患者进行了回顾性队列研究.
- 记录了 VE/VCO2 的斜率和 PetCO2.2.
- 用过的接收器运行特征分析,以确定90%特异性的值.
主要成果:
- 在PetCO2和VE/VCO2斜率 (r=-.88) 之间发现了强烈的负相关性.
- 在食道癌中MCPC/死亡的显著值:VE/VCO2斜率>38和PetCO2<4.1kPa.
- 使用VE/VCO2斜率 (0.70) 和PetCO2 (0.71) 预测结果的曲线下的相似面积.
结论:
- 手术前的VE/VCO2斜率和PetCO2可以识别食道切除的高风险患者.
- PetCO2 显示出与 VE/VCO2 斜率相似的预后效用.
- 当CPET无法使用时,PetCO2是一种潜在的有用,更简单的替代CPET.
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