Oxygen Management During Cardiopulmonary Bypass: A Single-Center, 8-Year Retrospective Cohort Study
Oxygen Management During Cardiopulmonary Bypass: A Single-Center, 8-Year Retrospective Cohort Study
复制标题
DOI：
10.1053/j.jvca.2020.08.029
复制
发表时间：
2021-01-01
影响因子：
2.8
通讯作者：
Grocott, Hilary P.
中科院分区：
文献类型：
--
作者：
Grocott, Bronwen B.;Kashani, Hessam H.;Grocott, Hilary P.
目的：描述接受心脏手术的患者在体外循环（CPB）期间的机构氧气管理实践，包括8年研究期间的任何潜在变化。设计：一项回顾性队列研究。设置：三级护理心脏手术计划。参与者：在2010年1月1日至12月31日期间接受涉及CPB的心脏手术（伴或不伴低温停循环（HCA））的患者，2017.测量和主要结果：除了基线患者特征外，作者还记录了在8年研究期间随机选择的696例患者在CPB期间的动脉血氧分压（Pao（2））、吸入氧分数和混合静脉血氧饱和度。总体平均Pao（2）为255 +/- 48 mmHg，在8年研究期间无任何显著变化（p = 0.30）。HCA患者的平均Pao（2）显著高于无HCA患者（分别为327 +/- 93 mmHg vs 252 +/- 45 mmHg; p < 0.001）。结论：作者所在机构目前CPB期间的氧管理方法在高血氧水平范围内，并且这些方法没有随着时间的推移而改变。这些实践对患者结局的影响尚未完全了解，需要进行额外的研究以建立可靠的证据来指导CPB期间的最佳氧气管理实践。(C)2020爱思唯尔公司All rights reserved.
Objective: To characterize the institutional oxygen management practices during cardiopulmonary bypass (CPB) in patients undergoing cardiac surgery, including any potential changes during an 8-year study period.Design: A retrospective cohort study.Setting: A tertiary care cardiac surgical program.Participants: Patients who underwent cardiac surgery involving CPB, with or without hypothermic circulatory arrest (HCA), between January 1, 2010, and December 31, 2017.Measurements and Main Results: In addition to baseline patient characteristics, the authors recorded the partial pressures of arterial oxygen (Pao(2)), fraction of inspired oxygen, and mixed venous oxygen saturation during CPB of 696 randomly selected patients during an 8-year study period. The overall mean Pao(2) was 255 +/- 48 mmHg, without any significant change during the 8-year study period (p = 0.30). The mean Pao(2) of HCA patients was significantly higher than in patients without HCA (327 +/- 93 mmHg v 252 +/- 45 mmHg, respectively; p < 0.001).Conclusions: The current approach to oxygen management during CPB at the authors' institution is within the range of hyperoxemic levels, and these practices have not changed over time. The impact of these practices on patients' outcomes is not fully understood, and additional studies are needed to establish firm evidence to guide optimal oxygen management practice during CPB. (C) 2020 Elsevier Inc. All rights reserved.