Fot Evgenia V, Izotova Natalia N, Yudina Anjelika S, Smetkin Aleksei A, Kuzkov Vsevolod V, Kirov Mikhail Y
Department of Anesthesiology and Intensive Care Medicine, Northern State Medical University, Arkhangelsk, Russia.
Front Med (Lausanne). 2017 Aug 9;4:132. doi: 10.3389/fmed.2017.00132. eCollection 2017.
The early warning scores may increase the safety of perioperative period. The objective of this study was to assess the diagnostic and predictive role of Integrated Pulmonary Index (IPI) after off-pump coronary artery bypass grafting (OPCAB).
Forty adult patients undergoing elective OPCAB were enrolled into a single-center prospective observational study. We assessed respiratory function using IPI that includes oxygen saturation, end-tidal CO, respiratory rate, and pulse rate. In addition, we evaluated blood gas analyses and hemodynamics, including ECG, invasive arterial pressure, and cardiac index. The measurements were performed after transfer to the intensive care unit, after spontaneous breathing trial and at 2, 6, 12, and 18 h after extubation.
The value of IPI registered during respiratory support correlated weakly with cardiac index (rho = 0.4; = 0.04) and ScvO (rho = 0.4, = 0.02). After extubation, IPI values decreased significantly, achieving a minimum by 18 h. The IPI value ≤9 at 6 h after extubation was a predictor of complicated early postoperative period (AUC = 0.71; = 0.04) observed in 13 patients.
In off-pump coronary surgery, the IPI decreases significantly after tracheal extubation and may predict postoperative complications.
早期预警评分可能会提高围手术期的安全性。本研究的目的是评估非体外循环冠状动脉搭桥术（OPCAB）后综合肺指数（IPI）的诊断和预测作用。
40例接受择期OPCAB的成年患者被纳入一项单中心前瞻性观察研究。我们使用包括血氧饱和度、呼气末二氧化碳、呼吸频率和脉搏率的IPI来评估呼吸功能。此外，我们评估了血气分析和血流动力学，包括心电图、有创动脉压和心脏指数。测量在转入重症监护病房后、自主呼吸试验后以及拔管后2、6、12和18小时进行。
呼吸支持期间记录的IPI值与心脏指数（rho = 0.4；P = 0.04）和中心静脉血氧饱和度（rho = 0.4，P = 0.02）弱相关。拔管后，IPI值显著下降，在18小时时达到最低。13例患者中观察到拔管后6小时IPI值≤9是术后早期并发症的预测指标（AUC = 0.71；P = 0.04）。
在非体外循环冠状动脉手术中，气管拔管后IPI显著下降，并可能预测术后并发症。
