在数字健康时代重新思考心肺绕道管理
Youssef El Dsouki1,2, Ignazio Condello3, Roberto Lorusso1
1Department of Health, Medicine and Life Sciences, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, The Netherlands.
Mayo Clinic proceedings. Digital health
|March 2, 2026
概括
最少侵入性心脏手术提供了好处,但风险更长的心肺绕道 (CPB) 时间. 数字健康的进步,如人工智能驱动的预测模型,可以优化CPB期间的输液管理,以提高患者的安全性.
科学领域:
- 心血管外科心血管外科
- 医疗技术 医疗技术 医学技术
- 数字健康数字健康
背景情况:
- 最少侵入性和机器人心脏手术旨在减少创伤并改善恢复.
- 这些技术往往需要较长的心肺绕道 (CPB) 和大动脉十字时间比传统的胸骨切除术.
- 长时间的CPB持续时间与术后发病率和死亡率的增加有关,特别是在脆弱的患者中.
研究的目的:
- 解决心脏外科手术中较少侵入性访问与长时间的体外支持之间的悖论.
- 探索数字健康创新如何减轻与延长CPB时间相关的风险.
- 提出心脏外科手术中精密输液管理的框架.
主要方法:
- 从随机和观察性研究中对最小侵入性/机器人心脏手术结果的当代证据的审查.
- 分析用于手术内输液管理的数字健康方面的进展,包括高频数据采集和AI预测模型.
- 概念化整合数字数据流和患者特定的数字双胞胎用于动态输液监测和控制.
主要成果:
- 最少侵入性和机器人程序显示可比或改善的生存率和功能恢复.
- 延长CPB和大动脉紧时间与较高的功能障碍,神经事件和全身炎症风险有关.
- 数字健康工具提供了早期检测 perfusion 不平衡和代谢困扰的潜力.
结论:
- 通过数字健康和人工智能实现的精密输液,可以潜在地将最小侵入性的好处与生理安全相协调.
- 将CPB持续时间转换为数字监控,可优化的变量是一个关键的未来方向.
- 进一步的数字 perfusion 框架的多中心验证和标准化对于现实世界的实施是必要的.
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