Department of Anesthesiology, National Taiwan University College of Medicine and National University Hospital, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan, 10002.
National Taiwan University Cancer Center, No. 57, Ln. 155, Sec. 3, Keelung Rd., Da'an Dist., Taipei City, 106, Taiwan.
Sci Rep. 2023 Mar 21;13(1):4626. doi: 10.1038/s41598-023-31889-x.
Maintenance of normothermia is a critical perioperative issue. The warming process after hypothermia tends to increase oxygen demand, which may lead to myocardial ischemia. This study explored whether hypothermia was an independent risk factor for increased morbidity and mortality in patients receiving CABG. We conducted a retrospective observational study of CABG surgeries performed from January 2018 to June 2019. The outcomes of interest were mortality, surgical site infection rate, ventilator dependent time, intensive care unit (ICU) stay, and hospitalization duration. Data from 206 patients were analysed. Hypothermic patients were taller (p = 0.012), had lower left ventricular ejection fraction (p = 0.016), and had off-pump CABG more frequently (p = 0.04). Our analysis noted no incidence of mortality within 30 days. Hypothermia was not associated with higher surgical site infection rate or longer intubation time. After adjusting for sex, age, cardiopulmonary bypass duration, left ventricular ejection fraction, and EuroSCORE II, higher EuroSCORE II (p < 0.001; odds ratio 1.2) and hypothermia upon ICU admission (p = 0.04; odds ratio 3.8) were independent risk factors for prolonged ICU stay. In addition to EuroSCORE II, hypothermia upon ICU admission was an independent risk factor for prolonged ICU stay in patients receiving elective CABG.
维持正常体温是围手术期的关键问题。低温后的升温过程往往会增加氧气需求，从而导致心肌缺血。本研究探讨了低温是否是接受冠状动脉旁路移植术（CABG）的患者发病率和死亡率增加的独立危险因素。我们对 2018 年 1 月至 2019 年 6 月期间进行的 CABG 手术进行了回顾性观察性研究。我们感兴趣的结果是死亡率、手术部位感染率、呼吸机依赖时间、重症监护病房（ICU）停留时间和住院时间。对 206 名患者的数据进行了分析。低温患者更高（p=0.012），左心室射血分数更低（p=0.016），并且更频繁地进行非体外循环 CABG（p=0.04）。我们的分析没有发现 30 天内的死亡率。低温与较高的手术部位感染率或更长的插管时间无关。在调整性别、年龄、体外循环时间、左心室射血分数和 EuroSCORE II 后，较高的 EuroSCORE II（p<0.001；优势比 1.2）和 ICU 入院时的低温（p=0.04；优势比 3.8）是 ICU 停留时间延长的独立危险因素。除了 EuroSCORE II，ICU 入院时的低温是接受择期 CABG 的患者 ICU 停留时间延长的独立危险因素。
