在非心脏手术后康复的患者中新出现的术后低血压:一项前性观察性研究
Phillip Hoppe1, Yuan Chang, Tobias Schwarz
1From the Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (PH, YC, TS, AB, KKT, AK, MF, BS), the Department of Anesthesiology, the First Affiliated Hospital of Kunming Medical University, Kunming, China (YC), the Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (LK), the Department of Anesthesiology and OUTCOMES RESEARCH Center, University of Texas Health Science Center (DIS), the OUTCOMES RESEARCH Consortium, Houston, Texas, USA (KKT, DIS, BS).
在非心脏手术后,在41%的患者中,术后的平均动脉压低于65mmHg. 新出现的低血压,定义为至少5mmHg低于基线的下降,在所有患者中的18%观察到.
科学领域:
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 心血管生理学心血管生理学
背景情况:
- 术后平均动脉压 (MAP) 低于65mmHg的临床意义尚不清楚,因为它可能代表个人正常压力范围.
- 了解新发作的术后低血压对于非心脏手术后的患者管理至关重要.
研究的目的:
- 在接受非心脏手术的患者中评估术后动脉压.
- 为了确定新出现的术后低血压的发病率,定义为MAP<65 mmHg和与基线相比至少下降5 mmHg.
主要方法:
- 在德国一所大学医学中心进行的前性观察研究 (2020年10月 - 2021年9月).
- 包括心血管风险较高,在全身麻醉下进行非心脏手术的患者.
- 在手术前和后,每30分钟间隔监测大约24小时的血压.
主要成果:
- 最终分析包括了248名患者.
- 41%的患者 (101/248) 在术后至少有一次MAP<65 mmHg.
- 新发作的术后低血压发生在所有患者中的18% (44/248),而23% (57/248) 的MAP<65 mmHg,但不符合新发性低血压的标准.
结论:
- 在非心脏手术后,大约40%的患者经历了MAP<65mmHg.
- 大约一半的这些病例代表了新出现的术后低血压,强调了需要个性化MAP评估的必要性.
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