Toraman Fevzi, Evrenkaya Serdar, Senay Sahin, Karabulut Hasan, Alhan Cem
Department of Cardiovascular Surgery, Acibadem Kadikoy Hospital, Istanbul, Turkey.
Asian Cardiovasc Thorac Ann. 2007 Aug;15(4):303-6. doi: 10.1177/021849230701500407.
Although an adverse influence of hyperoxemia during cardiopulmonary bypass is well documented, there is a wide range of oxygen settings during cardiopulmonary bypass, based mostly on trial and error. The aim of this study was to determine the optimal inspired oxygen fraction during cardiopulmonary bypass. Ninety patients undergoing isolated coronary artery bypass operations were randomly allocated to one of 3 groups of 30 each. In group 1, cardiopulmonary bypass was started with an inspired oxygen fraction of 0.40, increased to 0.60 during rewarming. These settings were 0.40 and 0.50 in group 2, and 0.35 and 0.45 in group 3. Samples for blood gas analysis were collected at defined time periods during the operation. PaO(2) was significantly higher in groups 1 and 2 compared to group 3. All patients in group 1 and 88% of patients in group 2 suffered at least one episode of hyperoxemia during cardiopulmonary bypass, compared to 30% of patients in group 3. The differences were significant, and we concluded that to avoid hyperoxemia, inspired oxygen fraction should be kept at 0.35 during cardiopulmonary bypass and increased to 0.45 during rewarming.
尽管体外循环期间高氧血症的不良影响已有充分记录，但体外循环期间的氧设置范围很广，主要基于反复试验。本研究的目的是确定体外循环期间的最佳吸入氧分数。90例行单纯冠状动脉搭桥手术的患者被随机分为3组，每组30例。第1组体外循环开始时吸入氧分数为0.40，复温期间增至0.60。第2组的设置为0.40和0.50，第3组为0.35和0.45。在手术过程中的特定时间段采集血气分析样本。与第3组相比，第1组和第2组的动脉血氧分压（PaO₂）显著更高。第1组所有患者和第2组88%的患者在体外循环期间至少发生一次高氧血症，而第3组为30%。差异具有显著性，我们得出结论，为避免高氧血症，体外循环期间吸入氧分数应保持在0.35，复温期间增至0.45。
