双边肺移植后的下潮气体通风与没有呼吸机的日子有关
Stephen Morgan1,2, Anders Aneman2,3, Nick Olsen2
1St. Vincent's Hospital, Sydney, New South Wales, Australia.
Acta anaesthesiologica Scandinavica
|March 27, 2025
概括
低潮流体积通风,根据供体大小进行索引,改善了双边肺移植后的无呼吸器日. 这种做法与移植接受者的90天生存率更好有关.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 移植手术 移植手术
背景情况:
- 关于双边肺移植后的机械通风策略的证据有限.
- 目前的做法可能会导致长时间的通风,特别是当被索引到捐赠者人类学时.
研究的目的:
- 为了研究潮体积通风与捐赠者预测体重对双边肺移植后结果的影响.
- 为了确定潮体积策略与无呼吸器日和90天生存率之间的关联.
主要方法:
- 对111名成年双边肺移植接受者 (2015-2021) 进行回顾性队列研究,呼吸时间≥24小时.
- 根据捐赠者/接受者预测的体重,患者被分为较低和较高的潮体积子组.
- 主要结局:28天的无呼吸器日;使用威尔科克森等级总和测试和竞争性风险回归分析;用于生存分析的Cox比例危险模型.
主要成果:
- 低潮水体积与捐赠者预测的体重指数相关,与更多无呼吸器日相关 (p=0.04在48h,p=0.02在72h).
- 低潮量也与成功出率的增加有关 (SHR 1.54,p=0.02在48小时;SHR 1.87,p=0.03在72小时).
- 更多的无呼吸器日和较低的潮体积与90天生存率的改善有关.
结论:
- 低潮量通风,根据捐赠者预测的体重进行索引,与双边肺移植后无呼吸器日的改善有关.
- 对于其他患者重要的结果没有观察到显著差异;建议进行更大的前性试验.
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