与式心脏手术相关的血管的定义:用元分析进行系统性审查
Patrick M Wieruszewski1,2,3, Jamel P Ortoleva4, Seth R Bauer5,6
1Department of Anesthesiology, Mayo Clinic, Rochester, MN.
Critical care explorations
|December 18, 2025
概括
血管,一种常见的心脏手术并发症,缺乏标准定义,导致发生率估计有所不同. 统一的定义对于一致的诊断和改善心脏外科手术患者的结果至关重要.
科学领域:
- 心血管外科心血管外科
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
背景情况:
- 血管是心脏手术中心肺旁路术后的常见和严重并发症.
- 目前血管的诊断标准不一致,阻碍了准确的发病率估计和比较分析.
- 这种变化有助于显著的患者发病率和死亡率.
研究的目的:
- 评估用于心脏外科手术中血管的各种诊断标准和定义.
- 评估这些定义的变化如何影响报告的血管发病率.
- 强调需要对血管的标准化定义.
主要方法:
- 在多个数据库 (Embase,MEDLINE,Scopus,Web of Science等) 中进行了系统的文献搜索. 和临床试验登记册.
- 包括的研究是随机临床试验和观察性研究,涉及经过心肺旁路心脏手术的成年人.
- 使用随机效应模型进行比例元分析来计算聚合发病率.
主要成果:
- 分析了68项涉及56580名患者的研究,揭示了血管的63个不同的定义.
- 共同的标准包括血压 (84%) 和心脏输出量 (74%),但具有高度可变的值.
- 血管的综合发病率为21%,相关的急性损伤为32%,死亡率为12%.
结论:
- 在抽血心脏手术后的血管的公布定义中存在显著的异质性.
- 缺乏共识定义使研究和临床实践复杂化.
- 建立一个统一的,国际对血管的定义是一个紧急的优先事项.
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