Correlation of Intraoperative End-Tidal Carbon Dioxide Concentration on Postoperative Hospital Stay in Patients Undergoing Pylorus-Preserving Pancreaticoduodenectomy.
Correlation of Intraoperative End-Tidal Carbon Dioxide Concentration on Postoperative Hospital Stay in Patients Undergoing Pylorus-Preserving Pancreaticoduodenectomy.
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DOI：
10.1007/s00268-021-05984-x
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发表时间：
2021-06
影响因子：
2.6
通讯作者：
Lee JR
中科院分区：
文献类型：
--
作者：
Park JH;Lee HM;Kang CM;Kim KS;Jang CH;Hwang HK;Lee JR
传统上提倡在全身麻醉期间发生低碳酸血症，尽管它可能引起有害的生理效应，导致患者的不良结局。本研究调查了在接受保留幽门的胰腺炎切除术（PPPD）的患者中，术中呼气末二氧化碳（EtCO 2）与住院时间（LOS）之间的关系。对2006年至2015年759例患者的病历进行了审查。根据全麻期间平均EtCO 2值将患者分为两组：低碳酸血症组（< 35 mmHg）和正常碳酸血症组（≥ 35 mmHg）。主要结局是两组之间的LOS。次要结局包括重症监护室（ICU）住院时间、术后30天、1年和2年死亡率以及与LOS相关的围手术期因素。最终共分析了727例患者。低碳酸血症组的中位LOS明显长于正常碳酸血症组（分别为22天和18天; p < 0.001）。两组的术后死亡率无差异。考克斯回归分析显示，低碳酸血症是导致LOS延长的独立危险因素（风险比[HR]，1.61; 95%可信区间[CI]，1.37-1.89; p < 0.001）。年龄和术后胰瘘也是延长LOS的危险因素。得出的结论是，全麻期间低水平的术中EtCO 2与接受PPPD的患者的LOS增加相关。
Hypocapnia has been traditionally advocated during general anesthesia, even though it may induce deleterious physiological effects that result in unfavorable outcomes in patients. This study investigated the association between intraoperative end-tidal carbon dioxide (EtCO2) and length of hospital stay (LOS) in patients who underwent pylorus-preserving pancreaticoduodenectomy (PPPD). The medical records of 759 patients from 2006 to 2015 were reviewed. The patients were divided into two groups based on the mean EtCO2 value during general anesthesia: the hypocapnia group (< 35 mmHg) and the normocapnia group (≥ 35 mmHg). The primary outcome was LOS between the groups. Secondary outcomes included the length of intensive care unit (ICU) stay, postoperative 30-day, 1-year, and 2-year mortality, and perioperative factors associated with LOS. A total of 727 patients were finally analyzed. The median LOS of the hypocapnia group was significantly longer than that of the normocapnia group (22 days vs. 18 days, respectively; p < 0.001). Postoperative mortality did not differ between the groups. Cox regression analysis revealed that hypocapnia was an independent risk factor for longer LOS (hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.37–1.89; p < 0.001). Age and postoperative pancreatic fistula were also risk factors for a longer LOS. It was concluded that low levels of intraoperative EtCO2 during general anesthesia were associated with an increased LOS for patients undergoing PPPD.
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DOI：
10.1186/s13054-015-1067-6
发表时间：
2015-09-29
期刊：
Critical care (London, England)
影响因子：
--
作者：
Helmerhorst HJ;Roos-Blom MJ;van Westerloo DJ;Abu-Hanna A;de Keizer NF;de Jonge E
通讯作者：
de Jonge E
影响因子：
1.4
作者：
Way M;Hill GE
通讯作者：
Hill GE
影响因子：
3
作者：
Gittell, JH;Fairfield, KM;Zuckerman, J
通讯作者：
Zuckerman, J
影响因子：
3.6
作者：
Wax, David B.;Lin, Hung-Mo;Porter, Steven B.
通讯作者：
Porter, Steven B.
影响因子：
3.8
作者：
Bassi, C;Dervenis, C;Buchler, M
通讯作者：
Buchler, M