体外循环心脏直视手术后低氧的危险因素分析

Extracorporeal circulation ECC 2004 1 4 ECC 1 h 6 h 12 h 24 h ECC ECC ECC ECC ECC A Clinical Study on Risk Factors of Post Extracorporeal Circulation Hypoxemia Abstract 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 words Hypoxemia Oxygenation index Extracorporeal circulation Extracorporeal circulation ECC 1982 1988 1997 1999 PaO2 FiO2 300 mm Hg 1 ECC empirenews page 1 1 1 2004 1 4 ECC 1 2 LVEF ECC ECC ECC 1 h 6 h 12 h 24 h PaO2 FiO2 PaO 2 FiO2 1 3 1 3 1 1 0 1 3 2 1 h 6 h 12 h 24 h PaO2 FiO2 1 h P0 01 300 mm Hg X2 t P0 05 2 2 1 175 1 1 0 2 2 2 72 103 2 3 4 2 P0 05 3 P0 05 4 P0 05 6h ECC ECC LVEF EC C ECC 3 ECC 2 ECC PaO2 FiO2 PaO2