Automated control of postoperative hypertension: a prospective, randomized multicenter study.
Automated control of postoperative hypertension: a prospective, randomized multicenter study.
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术后高血压的自动控制：一项前瞻性、随机多中心研究。
DOI：
10.1016/0003-4975(89)90117-3
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发表时间：
1989
期刊：
影响因子：
--
通讯作者：
L. Cohn
中科院分区：
文献类型：
--
作者：
D. Cosgrove;J. Petre;J. L. Waller;J. Roth;C. Shepherd;L. Cohn
心脏手术后高血压是一种常见的现象。由此引起的并发症包括出血、血管缝合线断裂、内膜下缺血和可能的脑血管意外。硝普钠治疗已成为预防这些并发症的公认做法。为了改善对动脉血压的控制，开发了用于硝普钠给药的闭环系统。在180例心脏手术患者中进行了一项前瞻性、随机、多中心研究，以评价该系统与手动控制输注相比的性能。平均动脉压在目标血压±10%范围内的依从性，自动系统为85%，手动调节为61%（p< 0.0001）。使用自动系统时，高血压（9%对22%;p< 0.0001）和低血压（6%对22%;p< 0.0001）较少。高血压的上级控制更快，对护士调节输注速率的要求更少。自动模式下，血压控制的上级导致胸管引流量减少（720 mL vs 840 mL;p< 0.05）。
Hypertension after a cardiac operation is a frequent phenomenon. Complications resulting from this include bleeding, disruption of vascular suture lines, subendocardial ischemia, and possible cerebrovascular accidents. Treatment with sodium nitroprusside has become accepted practice to prevent these complications. To improve control of arterial blood pressure, a closed-loop system for sodium nitroprusside administration was developed. A prospective, randomized multicenter study was carried out postoperatively in 180 cardiac surgical patients to evaluate the performance of this system compared with manual control of infusion. Adherence of mean arterial blood pressure to ±10% of the target blood pressure occurred 85% of the time with the automatic system and 61% of the time with manual regulation (p< 0.0001). With the automatic system, there was less hypertension (9% versus 22%;p< 0.0001) and hypotension (6% versus 22%;p< 0.0001). The superior control of hypertension was achieved more rapidly with less requirement for nurse regulation of infusion rate. The superior control of blood pressure resulted in less chest tube drainage in the automatic mode (720 mL versus 840 mL;p< 0.05).