状静脉氧和乳酸盐参数用于预测在非冠状动脉旁路移植后早期认知功能障碍:一项前性观察性研究
Pooja Singh1, Ramees A Anchukandan1, Sunaina T Karna1
1Department of Anesthesiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
状静脉乳酸和氧气参数可以帮助预测术后认知功能障碍 (POCD) 在非抽动冠状动脉旁路移植 (OPCAB) 后. 修改后的乳酸氧指数 (mLOI) 显示出高灵敏度,而动脉关静脉乳酸差异 (AJDL) 显示出高特异性.
科学领域:
- 心血管外科心血管外科
- 神经科学是一个神经科学.
- 关键护理医学 关键护理医学
背景情况:
- 术后认知功能障碍 (POCD) 可能会在非抽动冠状动脉旁路移植 (OPCAB) 后对生活质量产生负面影响.
- 在OPCAB之后,静脉乳酸和POCD的氧气参数的预测值仍然不清楚.
研究的目的:
- 评估状静脉乳酸和氧气参数的灵敏度和特异性,以便在OPCAB患者中早期预测POCD.
- 为了比较患有POCD和没有POCD的患者之间的这些参数.
主要方法:
- 54名接受OPCAB治疗的患者的前性观察研究.
- 在超声波指导下进行柔球球道化,以测量乳酸和氧气参数.
- 通过神经心理测试评估认知功能;POCD定义为复合Z得分≥1.96或两个个别Z得分.
- 使用混评估方法评估的术后妄想 (POD) 强化护理单位得分.
主要成果:
- POD和POCD的发病率分别为18.5%和11.1%.
- 动脉关静脉乳酸差 (AJDL) 和修改的乳酸氧指数 (mLOI) 在POCD组 (D组) 在T3.3显著更高.
- mLOI在预测POCD方面表现出最高的灵敏度 (72.22%),而AJDL表现出最高的特异性 (90.7%).
结论:
- 状静脉乳酸和氧气参数,特别是mLOI和AJDL,显示出在OPCAB患者中早期预测POCD的潜力.
- mLOI具有高灵敏度,而AJDL在识别OPCAB后POCD风险患者时具有高特异性.
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