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术前轻度升高的肺动脉收缩压对胸腔镜肺叶切除术围手术期不良事件发生率的影响:一项观察性队列研究方案。

Effects of preoperative mildly elevated pulmonary artery systolic pressure on the incidence of perioperative adverse events undergoing thoracoscopic lobectomy: an observational cohort study protocol.

机构信息

Department of Anesthesiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, People's Republic of China.

Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, People's Republic of China.

出版信息

BMJ Open. 2023 Sep 25;13(9):e072084. doi: 10.1136/bmjopen-2023-072084.

DOI:10.1136/bmjopen-2023-072084
PMID:37748854
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10533698/
Abstract

INTRODUCTION

Echocardiography provides a non-invasive estimation of pulmonary artery systolic pressure (PASP) and is the first diagnostic test for pulmonary hypertension. Recent studies have demonstrated that PASP of more than 30 mm Hg related to increased mortality and morbidity. However, perioperative risks and management for patients with mildly elevated PASP are not well established. This study aims to explore the association between mildly elevated PASP and perioperative adverse outcomes.

METHODS AND ANALYSIS

This will be a retrospective cohort study conducted at Shanghai Pulmonary Hospital in Shanghai, China. Eligible patients are adults (≥18 years) who performed preoperative echocardiography and followed thoracoscopic lobectomy. Our primary objective is to determine the effect of preoperative mildly elevated PASP on the incidence of hypotension during surgery. Whether mildly elevated PASP is related to other perioperative adverse events (including hypoxaemia, myocardial injury, new-onset atrial fibrillation, postoperative pulmonary complications, 30-day readmission and 30-day mortality) will be also analysed. An estimated 2300 patients will be included.

ETHICS AND DISSEMINATION

The study has been approved by the institutional review board of Shanghai Pulmonary Hospital (approval No: 2022LY1143). The research findings intend to be published in peer-reviewed scientific publications.

TRIAL REGISTRATION NUMBER

Chinese Clinical Trial Registry (ChiCTR2200066679).

摘要

简介

超声心动图可提供一种非侵入性的肺动脉收缩压(PASP)估计方法,是肺动脉高压的首选诊断测试。最近的研究表明,PASP 超过 30mmHg 与死亡率和发病率增加相关。然而,轻度升高的 PASP 患者的围手术期风险和管理尚不清楚。本研究旨在探讨轻度升高的 PASP 与围手术期不良结局之间的关系。

方法和分析

这将是一项在中国上海肺科医院进行的回顾性队列研究。纳入标准为接受术前超声心动图检查并接受胸腔镜肺叶切除术的成年患者(≥18 岁)。我们的主要目的是确定术前轻度升高的 PASP 对手术期间低血压发生率的影响。还将分析轻度升高的 PASP 是否与其他围手术期不良事件(包括低氧血症、心肌损伤、新发心房颤动、术后肺部并发症、30 天再入院和 30 天死亡率)相关。预计将纳入 2300 名患者。

伦理和传播

该研究已获得上海肺科医院机构审查委员会的批准(批准号:2022LY1143)。研究结果旨在发表在同行评议的科学出版物上。

临床试验注册号

中国临床试验注册中心(ChiCTR2200066679)。

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Perioperative cardiovascular pathophysiology in patients undergoing lung resection surgery: a narrative review.肺切除术患者围手术期心血管病理生理学:叙述性综述。
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Management of new onset atrial fibrillation in critically unwell adult patients: a systematic review and narrative synthesis.危重症成年患者新发房颤的管理:一项系统评价与叙述性综合分析
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