Lipo-prostaglandin E1 increases immediate arterial maximal flow velocity of free flap in patients undergoing reconstructive surgery
Lipo-prostaglandin E1 increases immediate arterial maximal flow velocity of free flap in patients undergoing reconstructive surgery
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DOI：
10.1111/aas.13217
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发表时间：
2019-01-01
影响因子：
2.1
通讯作者：
Kim, Young-Kug
中科院分区：
文献类型：
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作者：
Jin, Seok-Joon;Suh, Hyunsuk Peter;Kim, Young-Kug
背景在游离皮瓣手术中，皮瓣蒂血管吻合后维持适当的血流是很重要的。脂质体前列腺素E1（lipo-PGE 1）已经验性地管理，以防止血流不足的游离皮瓣重建。我们测试了我们的假设，脂质体PGE 1管理增加动脉流入的游离皮瓣。我们还评估了脂质体前列腺素E1相关的血流动力学变化和并发症。游离皮瓣血管吻合后10分钟给予Lipo-PGE 1。应用双功超声测量游离皮瓣血管蒂动脉在给予脂质体前列腺素E1前和给予脂质体前列腺素E1后30分钟的最大血流速度。主要结果是最大血流速度的差异之前和后30分钟的lipo-PGE 1管理。同时测量动脉血压、心率、心输出量、每搏输出量变异度和脉压变异度。还研究了Lipo-PGE 1相关并发症，如低血压、心动过缓、体温过低、面部潮红、腹泻、呼吸暂停和癫痫发作。结果与给予脂质体PGE 1前相比，给予脂质体PGE 1后30分钟的最大血流速度明显增加（平均值（标准差）：26.3（8.7）cm/s vs 22.5（8.0）cm/s，P = 0.002）。给药前和给药后30分钟的血流动力学参数无显著差异。结论Lipo-PGE 1可显著提高游离皮瓣修复术后患者的最大血流速度，且无并发症，是一种有效、安全的维持足够血流量的方法。
Background In free flap surgery, the maintenance of proper blood flow after anastomosis of flap pedicle vessels is important. Lipo-prostaglandin E1 (lipo-PGE1) has been empirically administered to prevent blood flow insufficiency in a free flap reconstruction. We tested our hypothesis that lipo-PGE1 administration increases the arterial inflow of free flap. We also evaluated lipo-PGE1-related haemodynamic changes and complications.Methods Thirty-seven patients who underwent free flap reconstruction were analysed. Lipo-PGE1 was administered 10 minutes after the vascular anastomosis of the free flap. The maximal blood flow velocity was measured at the free flap pedicle artery before and 30 minutes after lipo-PGE1 administration using duplex ultrasonography. The primary outcome was the difference in the maximal blood flow velocity before and 30 minutes after lipo-PGE1 administration. The arterial blood pressure, heart rate, cardiac output, stroke volume variation, and pulse pressure variation were measured simultaneously. Lipo-PGE1-related complications such as hypotension, bradycardia, hypothermia, facial flushing, diarrhoea, apnoea, and seizure were also investigated. Results The maximal blood flow velocity was significantly increased at 30 minutes after lipo-PGE1 administration compared to the level before lipo-PGE1 administration (mean (standard deviation): 26.3 (8.7) cm/s vs 22.5 (8.0) cm/s, P = 0.002). The haemodynamic variables were not significantly different before and 30 minutes after lipo-PGE1 administration. No lipo-PGE1-related complications occurred.Conclusions Lipo-PGE1 significantly increases the maximal blood flow velocity without complications in patients undergoing free flap reconstruction and may be an effective and safe method of maintaining adequate blood flow in these cases.