评估氧储量指数引导的氧化,以预防老年患者手术后妄想:一项随机对照试验
Pelin Uzun Sarıtaş, Aykut Sarıtaş1, Merve Çetin Poyraz
1Aykut Sarıtaş, Health Sciences University, Tepecik Training and Research Hospital, Department of Anesthesiology and Reanimation, İzmir, Turkey, aykut26tr@hotmail.com.
Croatian medical journal
|March 6, 2025
概括
导向氧气治疗的氧气储备指数 (ORi) 在老年患者中显著降低了术后妄想 (POD). 这种方法最大限度地减少了手术期间的高氧化血症,改善了术后的结果.
科学领域:
- 麻醉学 麻醉学
- 临界护理医学 临界护理医学
- 老年医学 老年医学
背景情况:
- 手术后痴呆症 (POD) 是老年手术患者的常见并发症.
- 手术期间的高氧化是POD的潜在危险因素.
- 目前的氧化监测可能无法充分预防高氧化症.
研究的目的:
- 为了评估氧气储备指数 (ORi) 引导的吸入氧气 (FiO2) 定位分量的有效性,以减少POD发病率.
- 评估ORI导向氧化对手术期间高氧化症发作的影响.
主要方法:
- 一项随机对照试验,涉及114名接受选择性手术的老年患者.
- 干预组:FiO2通过ORI和SpO2进行调整 (目标95%
- 对照组:FiO2仅使用SpO2进行调整;ORi记录但未用于定位. 使用CAM/CAM-ICU进行评估的POD.
主要成果:
- 在ORi+SpO2组中,POD发病率明显较低 (12.3%),与对照组相比 (42.1% (P<0.001).
- 在手术期间,ORi+SpO2组的平均FiO2水平显著降低 (P<0.001).
- 在ORi+SpO2组中发生的高氧化事件较少.
结论:
- 在老年手术患者中,ORI引导的氧化显著降低POD.
- 通过ORI监测尽量减少手术期间的高氧化,改善了外科手术期间的结果.
- 非侵入性ORI监测提供了一种优化手术内氧化的策略.
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