成人心脏直视手术中缓慢复温与快速复温对颈静脉球血氧饱和度的影响。
Effect of slow versus rapid rewarming on jugular bulb oxygen saturation in adult patients undergoing open heart surgery.
作者信息
Ali Mohmaed Shaaban, Sayed Sameh Abd Al Rhman, Mohamoud Maged Salah, Abd-Elshafy Sayed Kaoud, Almaz Mohamed Gomaa
机构信息
Departments of Anesthesia, Assiut University Hospital, Assiut, Egypt.
Department of Cardiothoracic Surgery Department, Assiut University Hospital, Assiut, Egypt.
出版信息
Saudi J Anaesth. 2014 Apr;8(2):178-82. doi: 10.4103/1658-354X.130698.
BACKGROUND
A debate has appeared in the recent literature about the optimum rewarming strategy (slow vs. rapid) for the best brain function. This study was designed to compare the effect of slow versus rapid rewarming on jugular bulb oxygen saturation (SjO2) in adult patients undergoing open heart surgery.
MATERIALS AND METHODS
A total of 80 patients undergoing valve and adult congenital heart surgery were randomly allocated equally to rapid rewarming group 0.5 (0.136)°C/min and slow rewarming group 0.219 (0.055)°C/min in jugular bulb sampling was taken before, during and after surgery. Surgery was done at cardiopulmonary bypass (CPB) temperature of 28-30°C and rewarming was performed at the end of the surgical procedure.
RESULTS
CPB time, rewarming period were significantly longer in the slow rewarming group. Significant difference was observed in the number of the desaturated patients (SjO2 ≤ 50%) between the two groups; 14 (35%) in rapid rewarming versus 6 (15%) in the slow rewarming group; P = 0.035 by Fisher's exact test.
CONCLUSIONS
Slow rewarming could reduce the incidence of SjO2 desaturation during rewarming in adult patients undergoing open heart surgery.
背景
近期文献中出现了关于最佳脑功能的最佳复温策略（缓慢复温与快速复温）的争论。本研究旨在比较缓慢复温与快速复温对接受心脏直视手术的成年患者颈静脉球血氧饱和度（SjO2）的影响。
材料与方法
总共80例接受瓣膜和成人先天性心脏病手术的患者被随机等分为快速复温组（0.5（0.136）℃/分钟）和缓慢复温组（0.219（0.055）℃/分钟），在手术前、手术期间和手术后采集颈静脉球样本。手术在体外循环（CPB）温度为28 - 30℃下进行，复温在手术结束时进行。
结果
缓慢复温组的CPB时间、复温期明显更长。两组之间未饱和患者（SjO2≤50%）的数量存在显著差异；快速复温组为14例（35%），而缓慢复温组为6例（15%）；经Fisher精确检验，P = 0.035。
结论
缓慢复温可降低接受心脏直视手术的成年患者复温期间SjO2不饱和的发生率。
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