Perioperative amino acid infusion improves recovery and shortens the duration of hospitalization after off-pump coronary artery bypass grafting
Perioperative amino acid infusion improves recovery and shortens the duration of hospitalization after off-pump coronary artery bypass grafting
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DOI：
10.1213/01.ane.0000240972.84337.7c
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发表时间：
2006-12-01
影响因子：
5.7
通讯作者：
Mizobe, Toshiki
中科院分区：
文献类型：
--
作者：
Umenai, Takako;Nakajima, Yasufumi;Mizobe, Toshiki
围手术期氨基酸输注有助于维持核心温度，改善妇科和骨科手术后患者的预后。在本研究中，我们前瞻性地研究了氨基酸输注对非体外循环冠状动脉旁路移植术（CABG）中食管核心温度和术后预后的影响。连续180例接受原发性选择性或紧急停泵CABG的患者随机分为两组：静脉氨基酸输注组（术前2 h开始输注4 kJ kg(-1) h）和生理盐水输注组（输注时间和生理盐水量相同）。手术结束时，生理盐水输注组食管核心温度为35.6（35.3-35.8）℃[平均值（95%可信区间）]，氨基酸输注组为36.1℃（35.9-36.3）℃（P = 0.01）。Kaplan-Meier分析显示，给予氨基酸的患者所需的术后机械通气时间明显短于给予生理盐水的患者[中位数（95%可信区间），3.0 (2.5-3.9)vs 4.5 (3.8-5.8) h；P = 0.01]。此外，重症监护病房住院时间[20 (19.5-38.4)vs 44 (21-45) h；P = 0.001]和适合出院的天数[10 (9-11)vs 12（11-13）天；P = 0.004]，服用氨基酸的患者的寿命明显缩短。非体外循环冠脉搭桥患者围手术期氨基酸输注可有效减少术中低温并改善术后恢复。
Perioperative amino acid infusion helps maintain core temperature and improves patient outcomes after gynecologic and orthopedic surgery. In the present study we prospectively determined the effect of amino acid infusion on esophageal core temperature and postoperative outcomes during off-pump coronary artery bypass grafting (CABG). One-hundred-eighty consecutive patients undergoing primary elective or urgent off-pump CABG were randomly divided into two groups: the IV amino acid infusion group (4 kJ kg(-1) h(-1) starting 2 h before surgery) and the saline infusion group (similar period and volume of saline infusion). The esophageal core temperature at the end of surgery was 35.6 (35.3-35.8)degrees C [mean (95% confidence interval)] in the saline infusion group and 36.1 degrees C (35.9-36.3)degrees C in the amino acid infusion group (P = 0.01). Kaplan-Meier analysis demonstrated that patients given amino acids required a significantly shorter duration of postoperative mechanical ventilation than patients given saline [median (95% confidence interval), 3.0 (2.5-3.9) vs 4.5 (3.8-5.8) h; P = 0.01]. Furthermore, intensive care unit stay [20 (19.5-38.4) vs 44 (21-45) h; P = 0.001] and days until fit for discharge from hospital [10 (9-11) vs 12 (11-13) days; P = 0.004] were significantly shorter in patients given amino acid. Perioperative amino acid infusion in patients undergoing off-pump CABG effectively minimizes intraoperative hypothermia and improves postoperative recovery.