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冠状动脉搭桥手术患者的阻塞性睡眠呼吸暂停与术后并发症:对预防策略的需求

Obstructive sleep apnea and postoperative complications in patients undergoing coronary artery bypass graft surgery: a need for preventive strategies.

作者信息

Amra Babak, Niknam Nasim, Sadeghi Mohsen Mir Mohammad, Rabbani Majid, Fietze Ingo, Penzel Thomas

机构信息

Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran ; Bamdad Sleep Research Center, Isfahan, Iran.

Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Int J Prev Med. 2014 Nov;5(11):1446-51.

Abstract

BACKGROUND

Obstructive sleep apnea (OSA) is very frequent and often unrecognized in surgical patients. OSA is associated with perioperative complications. We evaluated the effects of OSA on postoperative complications and hospital outcomes in patients undergoing coronary artery bypass graft (CABG) surgery.

METHODS

Candidates of elective CABG were evaluated by the Berlin questionnaire for OSA. After surgery, patients were assessed for postoperative complications, re-admission to the Intensive Care Unit (ICU), duration of intubation, re-intubation, days spent in the ICU and the hospital.

RESULTS

We studied 61 patients who underwent CABG from which 25 (40.9%) patients had OSA. Patients with OSA had higher body mass index (29.5 ± 3.9 vs. 26.0 ± 3.7 kg/m(2), P = 0.003) and higher frequency of hypertension (68.0% vs. 30.5%, P = 0.003), dyslipidemia (36.0% vs. 5.5%, P = 0.004), and pulmonary disease (16.0 vs. 2.7%, P = 0.08). Regarding the surgical outcomes, OSA patients had longer intubation duration (0.75 ± 0.60 vs. 0.41 ± 0.56 days, P = 0.03).

CONCLUSIONS

Obstructive sleep apnea is frequent, but unrecognized among patients undergoing CABG. In these patients, OSA is associated with prolonged intubation duration. Preventing these problems may be possible by early diagnosis and management of OSA in cardiac surgery patients. Further studies with larger sample of patients and longer follow-ups are required in this regard.

摘要

背景

阻塞性睡眠呼吸暂停(OSA)在外科手术患者中非常常见,且常常未被识别。OSA与围手术期并发症相关。我们评估了OSA对接受冠状动脉旁路移植术(CABG)的患者术后并发症和住院结局的影响。

方法

通过柏林问卷对择期CABG患者进行OSA评估。术后,对患者的术后并发症、再次入住重症监护病房(ICU)、插管持续时间、再次插管、在ICU和医院的住院天数进行评估。

结果

我们研究了61例接受CABG的患者,其中25例(40.9%)患有OSA。OSA患者的体重指数更高(29.5±3.9 vs. 26.0±3.7 kg/m²,P = 0.003),高血压发生率更高(68.0% vs. 30.5%,P = 0.003),血脂异常发生率更高(36.0% vs. 5.5%,P = 0.004),肺部疾病发生率更高(16.0% vs. 2.7%,P = 0.08)。关于手术结局,OSA患者的插管持续时间更长(0.75±0.60 vs. 0.41±0.56天,P = 0.03)。

结论

阻塞性睡眠呼吸暂停在接受CABG的患者中很常见,但未被识别。在这些患者中,OSA与插管持续时间延长有关。通过对心脏手术患者进行OSA的早期诊断和管理,可能预防这些问题。在这方面需要对更多患者样本进行更大规模的研究和更长时间的随访。

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