Umeda Yukio, Inoue Mizuki, Takahashi Yasuaki, Goto Kahori, Mori Teruki, Kumazaki Yasumasa, Ishihara Atsushi, Nakashima Masahiro, Tanihata Shintaro
Department of Cardiovascular Surgery, Gifu Prefectural General Medical Center, Gifu, Japan.
Kyobu Geka. 2020 Mar;73(3):183-186.
Passive orthostatism using a tilt table was introduced in patients with impaired oxygenation [Pao2/Fio(2 P/F) ratio < 300] after cardiovascular surgery. Our passive orthostatism protocol was as follows. Patient was transferred to a tilt table under endotracheal intubation with pulmonary artery catheter monitoring, and rested for 10 minutes in a supine position, followed by 45-degree tilt for 5 minutes, and then passive orthostatism at 60-degree for 25 minutes. P/F ratio was significantly improved during passive orthostatism. Improvement in P/F ratio was confirmed even 1 hour after completion of the protocol. No obvious adverse events were found throughout the protocol. On average, 15 hours (2~72 hours, median 4 hours) after the introduction of passive orthostatism, weaning from respirator was achieved.
对于心血管手术后氧合受损(动脉血氧分压/吸入氧分数值[Pao2/Fio(2 P/F) 比值]<300)的患者,采用倾斜台进行被动直立试验。我们的被动直立试验方案如下。患者在气管插管及肺动脉导管监测下被转移至倾斜台,先仰卧位休息10分钟,然后45度倾斜5分钟,接着60度被动直立25分钟。在被动直立试验期间,P/F比值显著改善。即使在试验方案完成1小时后,P/F比值的改善仍得到证实。在整个试验方案过程中未发现明显不良事件。平均而言,在引入被动直立试验后15小时(2至72小时,中位数4小时),患者实现了脱机。