Guinot Pierre-Grégoire, Badoux Louise, Bernard Eugénie, Abou-Arab Osama, Lorne Emmanuel, Dupont Hervé
Anaesthesiology and Critical Care Department, Amiens University Hospital, Place Victor Pauchet, Amiens, France; INSERM U1088, Jules Verne University of Picardy, Amiens, France.
Anaesthesiology and Critical Care Department, Amiens University Hospital, Place Victor Pauchet, Amiens, France.
J Cardiothorac Vasc Anesth. 2017 Aug;31(4):1190-1196. doi: 10.1053/j.jvca.2017.02.015. Epub 2017 Feb 3.
The objective of this study was to assess the association between increased central venous-to-arterial carbon dioxide difference (ΔPCO) following cardiac surgery with cardiopulmonary bypass and postoperative morbidity and mortality.
A prospective, observational, non-interventional study.
Three hundred ninety-three patients undergoing cardiac surgery with cardiopulmonary bypass.
The primary endpoint was the occurrence of one or more major postoperative complications. A ΔPCO ≥ 6 mmHg was considered to be abnormal. Data were first analyzed globally, and then according to 4 subgroups based on time course of ΔPCO during the study period: [(1) persistently normal ΔPCO; (2) increasing ΔPCO; (3) decreasing ΔPCO; and (4) persistently high ΔPCO].
A total of 238 of the 393 (61%) patients developed complications. The major postoperative complication rate did not differ among the 4 groups: 64% (n = 9) in group 1, 62% (n = 21) in group 2, 53% (n = 32) in group 3, and 62% (n = 176) in group 4 (p = 0.568). Mortality rates did not differ among the 4 groups (p > 0.05). ΔPCO was correlated weakly with perfusion parameters.
These results suggested that ΔPCO is not predictive of postoperative complications or mortality.
本研究的目的是评估心脏直视手术后中心静脉血与动脉血二氧化碳分压差（ΔPCO）升高与术后发病率和死亡率之间的关联。
一项前瞻性、观察性、非干预性研究。
393例接受心脏直视手术的患者。
主要终点是一种或多种主要术后并发症的发生。ΔPCO≥6mmHg被认为异常。数据首先进行整体分析，然后根据研究期间ΔPCO的时间进程分为4个亚组：[（1）ΔPCO持续正常；（2）ΔPCO升高；（3）ΔPCO降低；（4）ΔPCO持续升高]。
393例患者中有238例（61%）发生并发症。4组之间主要术后并发症发生率无差异：第1组为64%（n = 9），第2组为62%（n = 21），第3组为53%（n = 32），第4组为62%（n = 176）（p = 0.568）。4组之间死亡率无差异（p>0.05）。ΔPCO与灌注参数呈弱相关。
这些结果表明，ΔPCO不能预测术后并发症或死亡率。
