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冠状动脉旁路移植中的气体微栓塞和术后妄想
Vladimir Tutuš1,2, Milica Paunović1, Nina Rajović3
1Department of Anesthesia, University Clinical Centre of Serbia, 11000 Belgrade, Serbia.
Journal of clinical medicine
|July 29, 2025
概括
在心肺绕道术 (CPB) 期间,高气体微栓塞 (GME) 负载与冠状动脉绕道移植 (CABG) 后的术后狂妄症 (POD) 有关. 在CPB期间减少GME可能有助于预防这些患者的POD.
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:
- 手术后妄 (POD) 是大手术后的一个常见的神经认知并发症,特别是冠状动脉旁路移植 (CABG).
- POD与增加的发病率,死亡率和医疗保健成本有关.
- 气体微栓塞 (GME) 是心肺绕道 (CPB) 期间导致POD的潜在因素.
研究的目的:
- 调查心肺绕道 (CPB) 期间气态微栓塞 (GME) 的负载与术后狂妄 (POD) 的发生率之间的关联.
- 在接受选择性内CABG的患者中确定POD的预测因子.
主要方法:
- 一项观察性研究涉及102名接受选择性内CABG的患者.
- 用超声波微泡计数器测量气体微栓塞 (GME) 负载,该计数器在CPB期间放置在动脉和静脉线上.
- 在第一个术后一周内,对患者进行POD监测.
主要成果:
- 与没有POD的患者相比,患有POD的患者在动脉和静脉CPB线上表现出显著更高的GME计数和体积.
- 在POD患者中观察到较低的质量因子 (QF) 值和减少静脉动脉泡数量和体积的减少.
- 年龄较大,泡体积减少较少,QF值较低被确定为POD的独立预测因素.
结论:
- 在心肺绕道术 (CPB) 期间的气体微栓塞 (GME) 负载和CABG患者的术后狂妄 (POD) 的发展之间存在强烈的关联.
- 尽量减少GME生成并最大限度地从CPB电路中消除它们对于防止POD至关重要.
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