Grützner Henrike, Flo Forner Anna, Meineri Massimiliano, Janai Aniruddha, Ender Jörg, Zakhary Waseem Zakaria Aziz
Section for Pediatrics and Youth Medicine, Public Health Department, Leipzig City Government, Friedrich-Ebert-Straße 19 a, 04109 Leipzig, Germany.
Department of Anesthesiology and Intensive Care Medicine, Heart Center Leipzig, Strümpellstraße 39, 04289 Leipzig, Germany.
J Clin Med. 2021 Sep 28;10(19):4470. doi: 10.3390/jcm10194470.
The purpose of this study was to compare patients who underwent on- vs. off-pump coronary artery bypass surgery managed with a fast-track protocol. Between September 2012 and December 2018, = 3505 coronary artery bypass surgeries were managed with a fast-track protocol in our specialized post-anesthesia care unit. Propensity score matching was applied and resulted in two equal groups of = 926. There was no significant difference in ventilation time (on-pump 75 (55-120) min vs. off-pump 80 (55-120) min, = 0.973). We found no statistically significant difference in primary fast-track failure in on-pump (8.2% (76)) vs. off-pump (6% (56)) groups ( = 0.702). The secondary fast-track failure rate was comparable (on-pump 12.9% (110) vs. off-pump 12.3% (107), = 0.702). There were no significant differences between groups in regard to the post-anesthesia care unit, the intermediate care unit, and the hospital length of stay. Postoperative outcome and complications were also comparable, except for a statistically significant difference in PACU postoperative blood loss in on-pump (234 mL) vs. off-pump (323 mL, < 0.0001) and red blood cell transfusion (11%) and (5%, < 0.001), respectively. Our results suggest that on- and off-pump coronary artery bypass surgery in fast-track settings are comparable in terms of ventilation time, fast-track failure rate, and postoperative complications rate.
本研究的目的是比较接受快速康复方案管理的非体外循环与体外循环冠状动脉旁路移植术的患者。2012年9月至2018年12月期间，我们专业的麻醉后护理单元采用快速康复方案管理了3505例冠状动脉旁路移植术。应用倾向评分匹配法，最终得到两组各926例的相等样本量。通气时间无显著差异（体外循环组75（55 - 120）分钟，非体外循环组80（55 - 120）分钟，P = 0.973）。我们发现体外循环组（8.2%（76例））与非体外循环组（6%（56例））的主要快速康复失败率无统计学显著差异（P = 0.702）。次要快速康复失败率相当（体外循环组12.9%（110例），非体外循环组12.3%（107例），P = 0.702）。在麻醉后护理单元、中间护理单元和住院时间方面，两组之间无显著差异。术后结局和并发症也相当，但体外循环组与非体外循环组在麻醉后护理单元术后失血量（分别为234 mL和323 mL，P < 0.0001）以及红细胞输注（分别为11%和5%，P < 0.001）方面存在统计学显著差异。我们的结果表明，在快速康复模式下，体外循环和非体外循环冠状动脉旁路移植术在通气时间、快速康复失败率和术后并发症发生率方面具有可比性。
