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冠状动脉搭桥术后患者长时间机械通气的危险因素:一项范围综述

Risk Factors of Prolonged Mechanical Ventilation in Post Coronary Artery Bypass Graft Patients: A Scoping Review.

作者信息

Kumalasari Regina Indah, Kosasih Cecep Eli, Priambodo Ayu Prawesti

机构信息

Master Study Program, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, Indonesia.

Department of Critical Care and Emergency Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, Indonesia.

出版信息

J Multidiscip Healthc. 2025 Feb 17;18:903-915. doi: 10.2147/JMDH.S483973. eCollection 2025.

Abstract

Prolonged mechanical ventilation (PMV) following CABG surgery is associated with increased patient morbidity and mortality. A consensus has yet to be reached regarding the time limit for PMV. Various studies have identified factors that influence PMV in patients following CABG surgery, but a review has yet to synthesize the results systematically. This review aimed to identify the definition and factors associated with PMV in patients following isolated CABG surgery. This scoping review used the framework developed by Arksey and O'Malley (2005). Primary sources of information were searched through 5 databases: PubMed, Scopus, Oxford Academy, Sage, and CINAHL and two search engines: Science Direct and Google Scholar, accessed on October 25, 2023. Eight articles with a total of 12,178 participants were included in this review. The PMV time limits used in the studies varied from >12 hours to >48 hours. The factors affecting PMV were grouped into preoperative, intraoperative and postoperative, with factors that have a high influence, including NYHA class, acute kidney injury and mediastinitis. Differences in the number of factors examined, criteria, characteristics, and time limits of the PMV used to make the study's results vary. Establishing guidelines regarding PMV time limits is essential according to current conditions.

摘要

冠状动脉旁路移植术(CABG)后长时间机械通气(PMV)与患者发病率和死亡率增加相关。关于PMV的时间限制尚未达成共识。多项研究已确定影响CABG术后患者PMV的因素,但尚未有综述对这些结果进行系统整合。本综述旨在确定单纯CABG术后患者PMV的定义及相关因素。本范围综述采用了Arksey和O'Malley(2005年)开发的框架。通过5个数据库检索主要信息来源:PubMed、Scopus、牛津学术、Sage和CINAHL,以及两个搜索引擎:Science Direct和谷歌学术,检索时间为2023年10月25日。本综述纳入了8篇文章,共12178名参与者。研究中使用的PMV时间限制从>12小时到>48小时不等。影响PMV的因素分为术前、术中和术后因素,其中影响较大的因素包括纽约心脏协会(NYHA)分级、急性肾损伤和纵隔炎。用于研究的PMV所检查因素的数量、标准、特征和时间限制的差异导致研究结果各不相同。根据当前情况制定关于PMV时间限制的指南至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4469/11844213/cc75e62bb87f/JMDH-18-903-g0001.jpg

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