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术后谵妄不影响接受心脏瓣膜手术的老年患者的心肺运动试验。

Postoperative delirium does not affect cardiopulmonary exercise testing in aged patients undergoing cardiac valve surgery.

作者信息

Shimomoto Yuta, Mukaiyama Kana, Hori Takashi, Inaki Yuichirou, Masai Takafumi, Hayashi Yukio

机构信息

Rehabilitation and Cardiovascular Surgery, Sakurabashi-Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka, 530-0001, Japan.

Yoka Municipal Hospital, 1878-1, Yoka, Yoka-cho, Yabu, Hyougo, 667-8555, Japan.

出版信息

JA Clin Rep. 2022 Aug 13;8(1):64. doi: 10.1186/s40981-022-00553-0.

Abstract

BACKGROUND

The effect of delirium on cardiopulmonary exercise testing (CPX) is unknown. This retrospective study was to examine the effect of delirium on CPX at discharge in aged patients undergoing cardiac surgery.

METHODS

This study included seventy patients aged 70 or older undergoing cardiac valve surgery, who entered our ICU and were discharged from our hospital between June 2016 and July 2018. All patients received active exercise by our rehabilitation team from the first postoperative day and were performed a CPX on a cycle ergometer before discharge. The anaerobic threshold oxygen uptake and the slope of the relationship between carbon dioxide output and minute ventilation were examined. We obtained the patient's data, including patient's characteristics, cardiac function, anesthesia data, laboratory data, ICU data, and length of ICU and hospital stay. Data were analyzed by unpaired t test or Fisher's exact test. P < 0.05 was considered statistically significant.

RESULTS

Of the 70 patients, 21 patients experienced delirium during ICU stay. The delirium group needed longer administration of sedatives and longer ICU stay and showed higher CRP value and lower renal function but similar cardiopulmonary function before discharge from our hospital compared with the non-delirium group.

CONCLUSIONS

Patients with a history of delirium during ICU showed higher CRP value and lower renal function before discharge, but the CPX values at discharge were not significantly affected by delirium.

摘要

背景

谵妄对心肺运动试验(CPX)的影响尚不清楚。这项回顾性研究旨在探讨谵妄对接受心脏手术的老年患者出院时CPX的影响。

方法

本研究纳入了70例年龄在70岁及以上接受心脏瓣膜手术的患者,这些患者于2016年6月至2018年7月期间入住我院重症监护病房(ICU)并出院。所有患者自术后第一天起接受康复团队的积极运动训练,并在出院前在功率自行车上进行CPX。检测无氧阈摄氧量以及二氧化碳排出量与分钟通气量之间关系的斜率。我们获取了患者的数据,包括患者特征、心功能、麻醉数据、实验室数据、ICU数据以及ICU和住院时间。数据采用非配对t检验或Fisher精确检验进行分析。P < 0.05被认为具有统计学意义。

结果

70例患者中,21例在ICU住院期间发生谵妄。与非谵妄组相比,谵妄组需要更长时间使用镇静剂,ICU住院时间更长,且出院前CRP值更高,肾功能更低,但心肺功能相似。

结论

在ICU期间有谵妄病史的患者出院前CRP值更高,肾功能更低,但出院时的CPX值未受到谵妄的显著影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7315/9374849/b4de8ce4be02/40981_2022_553_Fig1_HTML.jpg

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