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肥胖患者体外循环后面罩吸氧疗法与高流量吸氧疗法的比较

Comparison of Mask Oxygen Therapy and High-Flow Oxygen Therapy after Cardiopulmonary Bypass in Obese Patients.

作者信息

Sahin Mazlum, El Helin, Akkoç Ibrahim

机构信息

Department of Cardiovascular Surgery, Haseki Teaching and Research Hospital, Istanbul, Turkey.

Department of Cardiovascular Surgery, Sisli Teaching and Research Hospital, Istanbul, Turkey.

出版信息

Can Respir J. 2018 Jan 28;2018:1039635. doi: 10.1155/2018/1039635. eCollection 2018.

Abstract

BACKGROUND

To clarify the efficiency of mask O and high-flow O (HFO) treatments following cardiopulmonary bypass (CPB) in obese patients.

METHODS

During follow-up, oxygenization parameters including arterial pressure of oxygen (PaO), peripheral oxygen saturation (SpO), and arterial partial pressure of carbon dioxide (PaCO) and physical examination parameters including respiratory rate, heart rate, and arterial pressure were recorded respectively. Presence of atelectasia and dyspnea was noted. Also, comfort scores of patients were evaluated.

RESULTS

Mean duration of hospital stay was 6.9 ± 1.1 days in the mask O group, whereas the duration was significantly shorter (6.5 ± 0.7 days) in the HFO group (=0.034). The PaO values and SpO values were significantly higher, and PaCO values were significantly lower in patients who received HFO after 4th, 12th, 24th, 36th, and 48th hours. In postoperative course, HFO leads patients to achieve better postoperative FVC ( < 0.001). Also, dyspnea scores and comfort scores were significantly better in patients who received HFO in both postoperative day 1 and day 2 ( < 0.001, < 0.001 and =0.002, =0.001, resp.).

CONCLUSION

Our study demonstrated that HFO following CPB in obese patients improved postoperative PaO, SpO, and PaCO values and decreased the atelectasis score, reintubation, and mortality rates when compared with mask O.

摘要

背景

阐明肥胖患者体外循环(CPB)后面罩给氧(O)和高流量给氧(HFO)治疗的效果。

方法

在随访期间,分别记录氧合参数,包括动脉血氧分压(PaO)、外周血氧饱和度(SpO)和动脉血二氧化碳分压(PaCO),以及体格检查参数,包括呼吸频率、心率和动脉压。记录肺不张和呼吸困难的情况。此外,评估患者的舒适度评分。

结果

面罩给氧组的平均住院时间为6.9±1.1天,而高流量给氧组的住院时间显著缩短(6.5±0.7天)(P=0.034)。在第4、12、24、36和48小时接受高流量给氧的患者,其PaO值和SpO值显著更高,PaCO值显著更低。在术后过程中,高流量给氧使患者术后用力肺活量(FVC)更好(P<0.001)。此外,在术后第1天和第2天接受高流量给氧的患者,其呼吸困难评分和舒适度评分也显著更好(分别为P<0.001、P<0.001以及P=0.002、P=0.001)。

结论

我们的研究表明,与面罩给氧相比,肥胖患者体外循环后采用高流量给氧可改善术后PaO、SpO和PaCO值,并降低肺不张评分、再插管率和死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1dc/5829344/2368b8bce4ea/CRJ2018-1039635.001.jpg

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