THE EFFECT OF CARDIOPULMONARY BYPASS ON PULMONARY GAS EXCHANGE: A PROSPECTIVE RANDOMISED STUDY
THE EFFECT OF CARDIOPULMONARY BYPASS ON PULMONARY GAS EXCHANGE: A PROSPECTIVE RANDOMISED STUDY
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体外循环对肺气体交换的影响：一项前瞻性随机研究
DOI：
10.1097/00000539-199904001-00123
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
G. Angelini
中科院分区：
文献类型：
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作者：
Cohen;Cox;R. Ascione;I. Davies;S. Linter;S. Pryn;I. Ryder;G. Angelini
方法。52例首次行冠脉搭桥的患者被随机分为两组，一组接受常温CPB，另一组接受无CPB的手术。排除已知肺部疾病或射血分数低于30%的患者。麻醉和灌注技术标准化。所有使用乳腺内动脉的病例均打开胸膜。(1)麻醉诱导前，呼吸空气时测量Aa梯度；(2)诱导后，预切开；(3)术后重症监护病房；拔管后6小时。测量2、3和4的FiO 2 s分别为0.35、0.55和0.75。两组患者特征相似。麻醉前、麻醉后各组间Aa梯度差异无统计学意义。此后，两组Aa梯度逐渐升高（p< 0.05, 3 way ANOVA）。在围手术期的任何阶段，没有发现两组之间的差异，研究了任何FiO 2水平
Methods. Fifty two patients scheduled for first time CABG were randomised to receive either normothermic CPB, or surgery without CPB. Patients with known pulmonary disease or ejection fraction less than 30% were excluded. The anaesthetic and perfusion techniques were standardised. The pleura was opened for all cases in which the internal mammary artery was used. Aa gradients were measured (1) prior to anesthetic induction, while breathing air;(2) post induction, pre-incision;(3) postoperatively in the intensive care unit;(4) six hours following extubation. Measurements 2, 3 and 4 were each taken with FiO 2 s of 0.35, 0.55 and 0.75.Results. Patient characteristics were similar in the two groups. There were no significant differences between the groups in the Aa gradients taken before or after induction of anesthesia. Thereafter, Aa gradients rose progressively in both groups (p< 0.05, 3 way ANOVA). No differences were found between the groups at any stage during the perioperative period, with any of the FiO 2 levels studied