在心脏外科手术后的患者中,血液培养的积极性和血流感染的临床相关性
Jonathan M Curley1, Akram M Zaaqoq1, Siny Tsang1
1Department of Anesthesiology, University of Virginia Health, Charlottesville, VA.
Journal of cardiothoracic and vascular anesthesia
|July 27, 2025
概括
心脏手术患者的血流感染 (BSI) 阳性率为8.9%. 造成BSI的危险因素包括末期病,血栓缩和机械通风,但不包括发烧或白细胞病.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 血流感染 (BSI) 是心脏手术后患者的一个重大问题,可能会增加发病率和死亡率.
- 早期识别风险因素对于及时干预和改善患者结果至关重要.
研究的目的:
- 为了确定心脏手术后重症监护室 (ICU) 患者血液培养的阳性率.
- 确定与该患者群体中BSI发展独立相关的临床变量.
主要方法:
- 一个回顾性队列研究在一个中心进行.
- 分析了2018年7月至2023年6月期间接受血培养的3095名心脏手术患者的数据.
- 使用多变量通用线性混合效应回归来确定BSI的独立预测因子.
主要成果:
- 在接受血培养的533名患者中,115名 (8.9%) 对BSI.有阳性结果.
- 独立地与BSI相关的是:全肠道营养 (几率比[OR] = 5.44),严重的血小板缺血 (OR = 3.75),末期脏病 (OR = 2.19),机械呼吸 (OR = 1.92) 和心率>100 bpm (OR = 1.70).
- 发烧和白细胞瘤与培养阳性BSI没有显著关联.
结论:
- 几种临床因素,包括末期脏病,心动减速,最近的机械通风,严重的血小板缺血和全腹营养,与术后心脏手术患者的BSI有关.
- 由于发烧/白细胞瘤和BSI之间没有关联,因此需要进一步调查.
- 建议对这些已识别的风险因素进行前性验证,以帮助临床决策确定高风险患者.
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