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在开放胸前大动脉手术中进行外科手术期间高剂量补充:对SUSTAIN CSX试验的后期小组分析

Daniel Catena^1,2,3, Christian Stoppe^1,2,3,4, Ghaith Mohsen^1,2

¹Department of Cardiac Anesthesiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité-Medical Heart Center of Charité and German Heart Institute Berlin, Berlin, Germany.

Journal of thoracic disease

|March 12, 2026

概括

高剂量补充剂没有降低30天死亡率在开放胸前大动脉手术患者. 这种干预与术后心房动 (POAF) 的更高率有关.

科学领域:

心血管外科心血管外科
关键护理医学关键护理医学
营养科学营养科学

背景情况:

开放胸大动脉手术会引发严重的术后炎症,可能导致器官损伤和延长ICU停留时间.
正在探索抗炎策略,以减轻这些不良结果.
在SUSTAIN-CSX试验中,评估了手术前心脏手术患者的高剂量.

研究的目的:

评估术前高剂量补充剂对接受开放胸前大动脉手术的患者30天死亡率和器官功能障碍的影响.
分析来自SUSTAIN-CSX试验的子组数据,用于这个特定的患者群体.

主要方法:

在多中心SUSTAIN-CSX随机对照试验中对287名患者进行了后期分析.
患者接受了高剂量的静脉 (2000微克诱导,2000微克术后,1000微克每天长达10天) 或安慰剂.
排除标准包括胸前动脉的内血管干预.

主要成果:

(2.8%) 和安慰剂 (3.5%) 组之间30天死亡率没有显著差异 (P=0.73).
临床相关的术后心房动 (POAF) 在组 (18.1%) 与安慰剂 (10.5%) (P=0.03) 相比更频繁.
非心脏器官功能障碍 (AKI,妄,SOFA得分) 和炎症标志物是可比的;在组中,降低CK-MB的趋势并不显著.

结论:

术后高剂量补充剂在开放胸前大动脉手术中没有改善30天死亡率.
补充剂与POAF的发病率增加有关.
根据这项探索性分析,不建议对这组患者进行常规补充.

关键词:

心脏外科手术是一项心脏手术.大动脉外科手术心房动是心房动的一种.这是一种炎症炎症炎症炎症.是一种.

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