体外循环心脏直视手术后低氧的危险因素分析.doc

Extracorporeal circulationECC 200414ECC1 h6 h12 h24 h ECCECCECCECC ECC A Clinical Study on Risk Factors of Post Extracorporeal Circulation HypoxemiaAbstract: OBJECTIVE To evaluate the preoperative, intraoperative and postoperative factors contributing to the development of hypoxemia within the first 24 hours after cardiac surgery. METHODS 175 adult patients who accepted cardiac surgery with extracorporeal circulations (ECC) between Jan and Apr of 2004 were studied. Preoperative clinical and laboratory data were recorded, as were intraoperative and postoperative data regarding the PaO2/FiO2 ratio, fluid and drug therapy. Data analysis evaluated hypoxemia as depicted by the PaO2/FiO2 ratio at 1, 6, 12 and 24 hours after surgery. The risk factors were analyzed in 3 separate periods: preoperative, intraoperative and postoperative. Univariate and multivariate analyses were performed on each period separately. RESULTS Signiftcant risk factors for hypoxemia were age, reduced cardiac function, high creatinine level, pulmonary hypertension, prolonged ECC time, needing of dopamine and milrinone after surgery. CONCLUSION This study shows that the risk factors for hypoxemia were multifarious. The preventive measures should be taken during preoperative, intraoperative and postoperative.Key wordsHypoxemia; Oxygenation index; Extracorporeal circulationExtracorporeal circulationECC1982198819971999PaO2/FiO2300 mm Hg1ECC!-empirenews.page-1 1.1 200414ECC1.2 LVEFECCECCECC1 h6 h12 h24 hPaO2FiO2PaO2 /FiO21.3 1.3.1 101.3.2 1 h6 h12 h24 hPaO2FiO21 hP<0.01 300 mm HgX2tP<0.052 2.1 17511 0.22.2 721032342 ()*P<0.053 ()*P<0.054 ()*P<0.05*6h ECCECCLVEFECCECC3 ECC2%ECCPaO2F