一个肺通风期间的大脑高氧和水平预测胸部手术后更好的认知和临床结果:一项回顾性观察性研究
Ignacio Garutti1,2,3, Francisco de la Gala1,3, Javier Hortal1,2,3
1Departamento de Anestesia y Reanimación Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo 46, 28009 Madrid, Spain.
在胸部外科手术中,在单肺通风 (OLV) 期间保持高的手术内区域大脑氧和 (rScO) 与更好的术后认知功能和结果有关. 这项研究探讨了超正常rScO2水平的好处.
科学领域:
- 麻醉学 麻醉学
- 神经外科 神经外科
- 胸部外科手术 胸部外科手术
背景情况:
- 在单肺通风 (OLV) 期间的大脑不和与术后认知功能障碍 (POCD) 有关.
- 低的手术内区域大脑氧和 (rScO) 有已知的不良影响.
- 维持超正常rScO的好处还没有被充分理解.
研究的目的:
- 调查OLV期间维持超正常rScO2水平的临床价值.
- 在OLV期间,将高与低rScO2的患者之间的认知功能和术后结果进行比较.
主要方法:
- 对接受选择性胸部手术的成年患者进行了回顾性观察性研究.
- 患者分为高 (rScO2 ≥75%) 和低 (rScO2 <75%) 的平均INVOS组,分30分钟进入OLV.
- 对手术内变量,炎症生物标志物,认知功能 (MMSE) 和术后结果的分析.
主要成果:
- 高rScO2组在手术前有更好的肺功能,在手术内有更高的PaO2和PaCO2,以及更高的血红蛋白.
- 高rScO2组表现出更好的认知保存,在手术后24小时降低IL-18和更短的住院时间.
- 没有观察到手术内血动力学或呼吸机力学方面的显著差异.
结论:
- 在OLV期间保持超正常rScO (≥75%) 可能会保持认知功能并改善胸部手术后术结果.
- 较高的手术内氧化和血红蛋白水平与更好的结果有关.
- 需要进一步的研究来证实针对超常态rScO的临床实用性.
更多相关视频
07:51Standardized Hemorrhagic Shock Induction Guided by Cerebral Oximetry and Extended Hemodynamic Monitoring in Pigs
Published on: May 21, 2019
08:35Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction
Published on: August 17, 2022
相关概念视频
Cardiopulmonary Resuscitation II: ACLS Airway Management
Assessment of Diffusion and Perfusion
The Role of Diffusion in Respiration
Diffusion is the process by which molecules move from an area of higher concentration to an area of lower concentration. In the respiratory system, this...
Special considerations while measuring oxygen saturation
Ensuring accuracy in vital sign recordings while prioritizing patient comfort and minimizing anxiety is...
Physiological Control of Respiration
Breathing, a seemingly passive process, is regulated by the respiratory center in the brainstem. This center coordinates the involuntary control of respirations, which means it occurs without conscious effort, ensuring a smooth and uninterrupted pattern.
Regulation of Ventilation
The body maintains ventilation by monitoring levels of carbon dioxide (CO2), oxygen (O2), and hydrogen ion concentration (pH) in the arterial blood. Among these factors, the level of CO2 plays a crucial...
Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
