Intraoperative High Tidal Volume Ventilation and Postoperative Acute Respiratory Distress Syndrome in Liver Transplant.
Intraoperative High Tidal Volume Ventilation and Postoperative Acute Respiratory Distress Syndrome in Liver Transplant.
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DOI：
10.1016/j.transproceed.2021.10.030
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发表时间：
2022-04
影响因子：
0.9
通讯作者：
Xia VW
中科院分区：
文献类型：
--
作者：
Yang J;Cheng D;Hofer I;Nguyen-Buckley C;Disque A;Wray C;Xia VW
机械通气在围手术期管理和患者预后中发挥着重要作用。尽管高潮气量 (HTV) 机械通气对重症监护病房的患者有害，但 HTV 通气对接受肝移植 (LT) 患者的影响尚未有报道。本研究的目的是确定术中 HTV 通气是否与急性呼吸窘迫综合征 (ARDS) 的发生有关。对 2013 年至 2018 年在三级医疗中心接受 LT 的患者进行了审查。在3个时间点记录潮气量：麻醉诱导后、肝再灌注前和手术结束时。患者被分为 2 组：HIV（>10 mL/kg 预测体重 [pBW]）和非 HTV（≤10 mL/kg pBW）。对2组进行比较。通过多变量逻辑模型确定独立风险因素。在 780 名 LT 患者中，85 名 (10.9%) 接受了 HTV 通气。女性性别以及实际体重与pBW之间较大的差异是HIV通气的独立危险因素。接受 HTV 通气的患者 ARDS 发生率显着高于接受非 HTV 通气的患者（10.3% vs 3.9%；P = .01）。在这项回顾性研究中，我们发现 LT 期间的 HTV 通气很常见，并且与 ARDS 的较高发生率相关。因此，LT手术期间应谨慎选择潮气量。需要更多使用前瞻性随机对照设计的研究。
Mechanical ventilation plays an important role in perioperative management and patient outcomes. Although mechanical ventilation with high tidal volume (HTV) is injurious in patients in the intensive care unit, the effects of HTV ventilation in patients undergoing liver transplant (LT) has not been reported. The aim of this study was to determine if intraoperative HTV ventilation was associated with the development of acute respiratory distress syndrome (ARDS). Patients undergoing LT between 2013 and 2018 at a tertiary medical center were reviewed. The tidal volume was recorded at 3 time points: after anesthesia induction, before liver reperfusion, and at the end of surgery. Patients were divided into 2 groups: HTV (>10 mL/kg predicted body weight [pBW]) and non-HTV (≤10 mL/kg pBW). The 2 groups were compared. Independent risk factors were identified by multivariable logistic models. Of 780 LT patients, 85 (10.9%) received HTV ventilation. Female sex and greater difference between actual body weight and pBW were independent risk factors for HTV ventilation. Patients who received HTV ventilation had a significantly higher incidence of ARDS (10.3% vs 3.9%; P = .01) than those who received non-HTV ventilation. In this retrospective study, we showed that HTV ventilation during LT was common and was associated with a higher incidence of ARDS. Therefore, tidal volume should be carefully selected during LT surgery. More studies using a prospective randomized controlled design are needed.
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影响因子：
3.7
作者：
Zhao, Wei;Ge, Xupeng;Xia, Victor W.
通讯作者：
Xia, Victor W.
影响因子：
5.7
作者：
Beitler JR;Malhotra A;Thompson BT
通讯作者：
Thompson BT
影响因子：
9.8
作者：
Deng, Qi-Wen;Tan, Wen-Cheng;Xu, Miao
通讯作者：
Xu, Miao
DOI：
10.1016/s0140-6736(14)60416-5
发表时间：
2014-08-09
期刊：
Lancet (London, England)
影响因子：
--
作者：
PROVE Network Investigators for the Clinical Trial Network of the European Society of Anaesthesiology;Hemmes SN;Gama de Abreu M;Pelosi P;Schultz MJ
通讯作者：
Schultz MJ
影响因子：
24.3
作者：
Ricard, JD;Dreyfuss, D;Saumon, G
通讯作者：
Saumon, G