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影响成年心脏手术患者术后使用双水平气道正压通气(BiPAP)的因素:一项回顾性队列研究。

Factors influencing the use of postoperative bilevel positive airway pressure (BiPAP) in patients undergoing adult cardiac surgery: A retrospective cohort study.

作者信息

Ahmed Syed S, Yousuf Muhammad S, Samad Khalid, Ullah Hameed, Siddiqui Khalid M

机构信息

Department of Anaesthesiology Aga Khan University Karachi Pakistan.

出版信息

Health Sci Rep. 2022 Oct 3;5(6):e873. doi: 10.1002/hsr2.873. eCollection 2022 Nov.

DOI:10.1002/hsr2.873
PMID:36210872
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9528758/
Abstract

BACKGROUND AND AIMS

Respiratory complications are one of the biggest challenges following cardiac surgery, which can lead to hypoxia and acute respiratory failure (ARF). The aim of this study to identify the factors led to BiPAP application for postoperative respiratory complications and its effectiveness as the main outcome measures after cardiac surgery.

METHODS

It was a retrospective cohort study with consecutive sampling technique. A total of 335 postcardiac surgery patients medical record was reviewed who were underwent for surgery from November 1, 2018 to November 30, 2019. 265 patients were finalized for the recruitment, five patients were excluded before the final analysis. Data of 260 patients were analyzed for compiling of results.

RESULTS

The mean age was 59 years. 196 (75.4%) patients were males and females were 64 (24.6%). Mean weight was 72 kg and mean body mass index (BMI) 26.67 kg/m BiPAP application was in 38 (14.6%) patients and significantly high in with high BMI, ( < 0.05). There are significant associations of BiPAP application patients with COPD ( < 0.05). Patients with positive fluid balance, cardiac dysfunction, and required inotropic support were significantly associated with BiPAP need ( < 0.05), respectively.

CONCLUSION

BiPAP is effective to treat ARF and other respiratory complications after adult cardiac surgeries. High BMI, atelectasis, and pneumonia are also the independent factors causing ARF. BiPAP can be a successful tool for preventing the adverse effects of postoperative pulmonary complications after cardiac surgery.

摘要

背景与目的

呼吸并发症是心脏手术后最大的挑战之一,可导致缺氧和急性呼吸衰竭(ARF)。本研究旨在确定心脏手术后导致应用双水平气道正压通气(BiPAP)治疗术后呼吸并发症的因素及其有效性作为主要观察指标。

方法

这是一项采用连续抽样技术的回顾性队列研究。回顾了2018年11月1日至2019年11月30日期间接受心脏手术的335例患者的病历。最终纳入265例患者,5例患者在最终分析前被排除。对260例患者的数据进行分析以汇总结果。

结果

平均年龄为59岁。男性196例(75.4%),女性64例(24.6%)。平均体重为72 kg,平均体重指数(BMI)为26.67 kg/m²。38例(14.6%)患者应用了BiPAP,且在BMI较高的患者中应用率显著更高(P<0.05)。应用BiPAP的患者与慢性阻塞性肺疾病(COPD)有显著相关性(P<0.05)。液体平衡为正、存在心脏功能障碍以及需要应用血管活性药物支持的患者分别与需要应用BiPAP有显著相关性(P<0.05)。

结论

BiPAP对治疗成人心脏手术后的ARF和其他呼吸并发症有效。高BMI、肺不张和肺炎也是导致ARF的独立因素。BiPAP可以成为预防心脏手术后肺部并发症不良影响的成功工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da63/9528758/6d84b9fb8965/HSR2-5-e873-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da63/9528758/6d84b9fb8965/HSR2-5-e873-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da63/9528758/6d84b9fb8965/HSR2-5-e873-g001.jpg

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