Augoustides John G, Pochettino Alberto, Ochroch E Andrew, Cowie Doreen, McGarvey Michael L, Weiner Justin, Gambone Andrew J, Pinchasik Dawn, Cheung Albert T, Bavaria Joseph E
Department of Anesthesia, Hospital of the University of Pennsylvania, Philadelphia, PA 19104-4283, USA.
J Cardiothorac Vasc Anesth. 2006 Feb;20(1):8-13. doi: 10.1053/j.jvca.2005.07.031.
The purpose of this study was to describe clinical predictors for prolonged length of stay in the intensive care unit (PLOS-ICU) after adult thoracic aortic surgery requiring standardized deep hypothermic circulatory arrest (DHCA); and to determine the incidence of PLOS-ICU after DHCA, univariate predictors for PLOS-ICU, and multivariate predictors for PLOS-ICU.
A retrospective and observational study. PLOS-ICU was defined as longer than 5 days in the ICU.
Cardiothoracic operating rooms and the ICU.
All adults requiring thoracic aortic repair with DHCA INTERVENTIONS: None.
The cohort size was 144. The incidence of PLOS-ICU was 27.8%. The mortality rate was 11.1%. Univariate predictors for PLOS-ICU were age, stroke, DHCA duration, vasopressor dependence >72 hours, mediastinal re-exploration for bleeding, and renal dysfunction. Multivariate predictors for PLOS-ICU were stroke, vasopressor dependence >72 hours, and renal dysfunction.
PLOS-ICU after DHCA is common. The identified multivariate predictors merit further hypothesis-driven research to enhance perioperative protection of the brain, kidney, and cardiovascular system.
本研究旨在描述成人胸主动脉手术后在需要标准化深低温停循环（DHCA）的情况下，重症监护病房（ICU）延长住院时间（PLOS-ICU）的临床预测因素；并确定DHCA后PLOS-ICU的发生率、PLOS-ICU的单因素预测因素以及PLOS-ICU的多因素预测因素。
一项回顾性观察研究。PLOS-ICU定义为在ICU住院时间超过5天。
心胸外科手术室和ICU。
所有需要进行DHCA胸主动脉修复的成年人。干预措施：无。
队列规模为144例。PLOS-ICU的发生率为27.8%。死亡率为11.1%。PLOS-ICU的单因素预测因素为年龄、中风、DHCA持续时间、血管升压药依赖超过72小时、因出血进行纵隔再次探查以及肾功能不全。PLOS-ICU的多因素预测因素为中风、血管升压药依赖超过72小时以及肾功能不全。
DHCA后PLOS-ICU很常见。所确定的多因素预测因素值得进一步开展基于假设的研究，以加强对脑、肾和心血管系统的围手术期保护。
