Ferrada Paula, Manzano-Nunez Ramiro, Lopez-Castilla Valeria, Orlas Claudia, García Alberto F, Ordonez Carlos A, Dubose Joseph J
Am Surg. 2019 Feb 1;85(2):167-172.
Hypovolemic patients can develop postintubation hypotension (PIH). Our objective is to review the literature regarding PIH and the association with mortality. We searched MEDLINE from inception to February 2018. A meta-analysis was performed to assess the effect of PIH on mortality. The results of the meta-analysis were reported in forest plots of the estimated effects of the included studies with a 95 per cent confidence interval. Heterogeneity was evaluated using the ² test, which corresponded to low (² < 25%), medium (² = 25-75%), and high (² > 75%) heterogeneity. We identified 243 records. Four studies were included in the meta-analysis. The studies reported 2044 patients with 36.8 per cent (n = 753) developing PIH. Data indirectly reflecting the hemodynamic status were available in three studies (n = 1117 patients). Overall mortality was 24.6 per cent (n = 503) and was significantly higher in patients that developed PIH [mortality, n (%): PIH = 250/753 (33.2%) 253/1291 (19.6%), < 0.001]. Patients that develop PIH have an increased mortality. Considering a targeted resuscitation in hypovolemic patients is pivotal to minimize PIH.
低血容量患者可发生插管后低血压（PIH）。我们的目的是回顾关于PIH及其与死亡率关联的文献。我们检索了自数据库建立至2018年2月的MEDLINE。进行了一项荟萃分析以评估PIH对死亡率的影响。荟萃分析结果在纳入研究的估计效应森林图中报告，置信区间为95%。使用I²检验评估异质性，其对应低异质性（I² < 25%）、中度异质性（I² = 25 - 75%）和高度异质性（I² > 75%）。我们识别出243条记录。四项研究纳入了荟萃分析。这些研究报告了2044例患者，其中36.8%（n = 753）发生PIH。三项研究（n = 1117例患者）有间接反映血流动力学状态的数据。总体死亡率为24.6%（n = 503），发生PIH的患者死亡率显著更高[死亡率，n（%）：PIH = 250/753（33.2%）对253/1291（19.6%），P < 0.001]。发生PIH的患者死亡率增加。考虑对低血容量患者进行目标导向性复苏对于将PIH降至最低至关重要。
