在心肺绕道术期间监测氧气输送:一项初步跨国实践调查
Salman Pervaiz Butt1, Drisya Paul2, Salman Abdulaziz3
1Perfusion Services, Heart Vascular and Thoracic Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.
Journal of cardiothoracic and vascular anesthesia
|September 24, 2025
概括
在心肺绕道术 (CPB) 期间对氧气输送 (DO2) 监测的全球实践显示出显著的变化. 使用目标导向的 perfusion (GDP),但成本和资源的限制阻碍了持续DO2监测的广泛采用.
科学领域:
- 心脏病学 心脏病学
- 心血管外科心血管外科
- 关键护理医学 关键护理医学
背景情况:
- 氧气输送 (DO2) 在心肺绕道 (CPB) 过程中对于组织输液至关重要.
- 在CPB期间标准化的DO2监测和值策略缺乏全球共识.
- 急性损伤 (AKI) 是心脏手术患者接受CPB的一项重大关注.
研究的目的:
- 评估在CPB期间DO2监测的全球实践.
- 评估目标导向输液 (GDP) 策略的认识和实施情况.
- 确定感知到的临床益处,包括AKI降低,以及DO2监测的障碍.
主要方法:
- 进行了一项跨界国际调查.
- 120名参与者,包括输液师,麻醉师和心脏外科医生做出了反应.
- 收集了DO2监测方法,目标参数和GDP实践的数据.
主要成果:
- 73.9%的中心实行目标导向输液 (GDP),在大量的中心采用率更高.
- 监测方法各不相同:48.7%使用连续设备,37.8%使用间歇计算.
- 超过80%的人保持了DO2值;血红蛋白目标为80-90g/L;心脏指数为2.4-2.6L/min/m2.
- 55%的GDP用户报告了AKI发病率的降低.
- 财务限制和有限的资源是持续监测的主要障碍.
结论:
- 在CPB期间观察到DO2监测的显著全球变化和使用不足.
- 由于成本和资源的可用性,GDP战略的广泛采用受到限制.
- 迫切需要制定国际指导方针和标准化CPB期间的DO2监测,以优化患者的治疗结果.
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