Continuous urine oxygen tension monitoring in patients undergoing cardiac surgery
Continuous urine oxygen tension monitoring in patients undergoing cardiac surgery
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DOI：
10.1016/s1053-0770(96)80137-6
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发表时间：
1996-08-01
影响因子：
2.8
通讯作者：
Miyake, T
中科院分区：
文献类型：
--
作者：
Kainuma, M;Yamada, M;Miyake, T
目的：评价体外循环(CPB)对心脏手术患者围手术期尿氧分压(PuO2)的影响，以及是否可以预测术后肾功能不全。设计：前瞻性临床研究。地点：大学研究室，大学附属医院。研究对象：98例连续接受冠状动脉旁路手术或瓣膜手术的成人患者。干预：通过在连接Foley导管的尿管中插入极谱电极来连续测量PuO2。测量和主要结果：CPB前PuO2恒定，CPB开始后逐渐下降。在CPB脱机时部分恢复，但直到手术结束才完全恢复到原来的水平。CPB后PUO2下降的患者术后血肌酐水平明显高于PUO2恒定者和增高者，CPB后PUO2的恢复幅度和恢复速度与术后血肌酐峰值显著相关。结论：PUO2检测心脏手术早期肾功能不全的可能性有待进一步研究。版权所有(C)1996，由WB。桑德斯公司
Objectives: To evaluate the effect of cardiopulmonary bypass (CPB) on urine oxygen tension (PuO2) and to determine whether perioperative PuO2 can predict postoperative renal dysfunction in patients undergoing cardiac surgery.Design: Prospective clinical study.Setting: A university research laboratory, a university-affiliated hospital.Participants: Ninety-eight consecutive adult patients undergoing coronary artery bypass surgery or valvular surgery.Interventions: PuO2 was continuously measured by inserting a polarographic electrode into the urinary tube connected to a Foley catheter.Measurements and Main Results: PuO2 was constant before CPB and then progressively decreased after the start of CPB. It partially recovered at weaning from CPB but did not completely return to its original level until the end of surgery. Postoperative serum creatinine concentrations were significantly higher in patients whose PuO2 decreased after CPB, as compared with those whose PuO2 was constant or increased, The amplitude and the rate of recovery in PuO2 after CPB were significantly associated with peak values of postoperative serum creatinine concentrations.Conclusions: These results suggest the possibility of PuO2 detecting an early stage of renal dysfunction in cardiac surgery, although further studies will be required to substantiate it. Copyright (C) 1996 by WB. Saunders Company