Intraoperative Oxygen Practices in Cardiac Surgery: A National Survey.
Intraoperative Oxygen Practices in Cardiac Surgery: A National Survey.
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DOI：
10.1053/j.jvca.2022.01.019
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发表时间：
2022-08
影响因子：
2.8
通讯作者：
中科院分区：
文献类型：
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作者：
描述目前全国范围内关于心脏手术术中氧滴定的观点和实践。前瞻性观察调查。美国各地的医院。心血管麻醉师和灌注师。将专家和共识衍生的电子调查发送给灌注师和心脏麻醉师，以评价当前术中给氧实践。提供者被问及在心脏外科手术的不同阶段使用的个体术中氧滴定实践。在研究电子数据采集（REDCap）中收集匿名回复。共有3，335名供应商被邀请参与，其中554名（317名麻醉师和237名灌注师）被纳入最终分析（17%的应答率）。在心肺转流（CPB）期间，灌注师报告的中位（四分位距[IQR]）目标范围为150（110-220）至-325 mmHg（250-400），而麻醉师报告的目标范围显著较低，为90（70-150）至-250 mmHg（158-400）（p值分别<0.0001和0.02）。这种差异在动脉血氧分压（PaO 2）范围较低时最为明显。灌注医师认为“过低”的PaO 2中位数为100 mmHg（IQR 80-125），而麻醉医师认为“过低”的PaO 2中位数为60 mmHg（IQR 60-75），麻醉医师报告了关闭和正在进行的旁路手术。认为“过高”的中位PaO 2为375 mmHg（IQR 300-400）（灌注师）和300 mmHg（IQR 200-400）（麻醉师）。因此，麻醉师报告说，PaO 2值显著较低时更舒适（p < 0.0001），与灌注师相比，认为PaO 2值较高不太理想（p < 0.0001）。这项调查表明，灌注师和麻醉师之间的氧气管理实践存在很大差异。CPB时氧合过度更常见。
To describe the current nationwide perspectives and practice regarding intraoperative oxygen titration in cardiac surgery. Prospective, observational survey. Hospitals across the United States. Cardiovascular anesthesiologists and perfusionists. Expert- and consensus-derived electronic surveys were sent to perfusionists and cardiac anesthesiologists to evaluate the current intraoperative practices around oxygen administration. Providers were asked about individual intraoperative oxygen titration practices used at different stages of cardiac surgical procedures. Anonymous responses were collected in the Research Electronic Data Capture (REDCap). A total of 3,335 providers were invited to participate, of whom 554 (317 anesthesiologists and 237 perfusionists) were included in the final analysis (17% response rate). During cardiopulmonary bypass (CPB), perfusionists reported a median (interquartile range [IQR]) target range from 150 (110–220)-to-325 mmHg (250–400), while anesthesiologists reported a significantly lower target range from 90 (70–150)-to-250 mmHg (158–400) (p values <0.0001 and 0.02, respectively). This difference was most pronounced at lower partial pressure of arterial oxygen (PaO2) ranges. The median PaO2 considered “too low” by perfusionists was 100 mmHg (IQR 80–125), whereas it was 60 mmHg (IQR 60–75) for anesthesiologists, who reported for both off and on bypass. The median PaO2 considered “too high” was 375 mmHg (IQR 300–400) for perfusionists and 300 mmHg (IQR 200–400) for anesthesiologists. Anesthesiologists, therefore, reported more comfort with significantly lower PaO2 values (p < 0.0001), and considered a higher PaO2 value less desirable compared with perfusionists (p < 0.0001). This survey demonstrated there was wide variation in oxygen administration practices between perfusionists and anesthesiologists. Hyperoxygenation was more common while on CPB.
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影响因子：
120.7
作者：
Girardis, Massimo;Busani, Stefano;Singer, Mervyn
通讯作者：
Singer, Mervyn
影响因子：
--
作者：
dos Reis, Edison Emidio;de Menezes, Livia Dutra;Lanaro Justo, Caio Cesar
通讯作者：
Lanaro Justo, Caio Cesar
DOI：
10.1053/j.jvca.2020.08.029
发表时间：
2021-01-01
影响因子：
2.8
作者：
Grocott, Bronwen B.;Kashani, Hessam H.;Grocott, Hilary P.
通讯作者：
Grocott, Hilary P.
影响因子：
2.5
作者：
Lopez, Marcos G.;Pretorius, Mias;Billings, Frederic T.
通讯作者：
Billings, Frederic T.
影响因子：
120.7
作者：
Kilgannon, J. Hope;Jones, Alan E.;Trzeciak, Stephen
通讯作者：
Trzeciak, Stephen