Denault André Y, Deschamps Alain, Couture Pierre
Department of Anesthesiology, Montréal Heart Institute and Université de Montréal, Quebec, Canada.
Semin Cardiothorac Vasc Anesth. 2010 Sep;14(3):165-82. doi: 10.1177/1089253210376673. Epub 2010 Jul 23.
Every year, more than 1 million patients worldwide undergo cardiac surgery. Because of the aging of the population, cardiac surgery will increasingly be offered to patients at a higher risk of complications. The consequence is a reduced physiological reserve and hence an increased risk of mortality. These issues will have a significant impact on future health care costs because the population undergoing cardiac surgery will be older and more likely to develop postoperative complications. One of the most dreaded complications in cardiac surgery is difficult separation from cardiopulmonary bypass (CPB). When separation from CPB is associated with right-ventricular failure, the mortality rate will range from 44% to 86%. Therefore, the diagnosis and the preoperative prediction of difficult separation from CPB will be crucial to improve the selection and care of patients and to prevent complications for this high-risk patient population.
全球每年有超过100万患者接受心脏手术。由于人口老龄化，心脏手术将越来越多地提供给并发症风险更高的患者。结果是生理储备减少，因此死亡风险增加。这些问题将对未来的医疗保健成本产生重大影响，因为接受心脏手术的人群年龄更大，术后更有可能出现并发症。心脏手术中最可怕的并发症之一是体外循环（CPB）困难脱机。当CPB脱机与右心室衰竭相关时，死亡率将在44%至86%之间。因此，CPB困难脱机的诊断和术前预测对于改善患者的选择和护理以及预防这一高危患者群体的并发症至关重要。
