研究心肺旁路过程中氧气混合器对降低开胸手术患者乳酸水平的有益影响

B. Karthikeyan, B. Rajesh, A. S. Mughilan, P. Anbukumar, Marwin Manoa Baylis
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引用次数: 0

摘要

心肺旁路(CPB)手术期间血清乳酸水平升高有多种原因,包括外周循环衰竭、血液稀释或过度使用肌力药物。这项前瞻性对比研究针对 150 名接受开胸手术的患者。这项前瞻性对比研究的对象是 150 名接受开胸手术的患者。患者被分为 A 组(75 名)和 B 组(75 名),A 组患者直接使用氧气流,不使用氧气混合器,B 组患者使用氧气混合器。对 CPB 期间的血清乳酸水平、术后水平和结果进行了监测,并对两组进行了比较。通过使用氧气混合器,平均 FIO2 为 38 %,足以将 PO2 维持在 168 mm Hg。A 组显示出严重的高氧血症(p 值<0.0001)和低碳血症,导致 CPB 期间出现严重的呼吸性碱中毒,大多数病例在术后立即出现严重的酸中毒。B 组患者的血清乳酸值在 CPB 1 小时时明显降低,降低了 3.1 毫摩尔/升,2 小时时降低了 3.8 毫摩尔/升,到达 ICU 时降低了 4.4 毫摩尔/升(P 值<0.0001)。研究证明,在 CPB 期间使用氧气混合器可改善开胸手术的术后效果。研究人员得出结论,使用氧气面罩是有益的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Study the beneficial effects of oxygen blender during cardiopulmonary bypass in reducing lactate levels in patients undergoing open-heart surgery
Serum lactate levels rise during Cardio-Pulmonary Bypass (CPB) surgery for a variety of reasons, including peripheral circulatory failure, haemodilution, or excessive use of inotropic agents. Additionally, it has been reported that elevated serum lactate levels during the perioperative period are strongly associated with the worst postoperative outcomes, including mortality.To find out the beneficial effects of an oxygen blender during cardiopulmonary bypass in reducing lactate levels in patients undergoing open-heart surgery.This Prospective comparative study was done on 150 patients who underwent open-heart surgeries. Patients were divided into group A-75 patients: with direct oxygen flow without oxygen blender, group B- 75 patients: with oxygen blender. The serum lactate levels during CPB, postoperative levels and outcomes were monitored and both the groups were compared.Average FIO2 of 38 % was enough to maintain PO2 of 168 mm Hg by using the oxygen blender with the flow rates. Group A showed severe hyperoxemia (p-value <0.0001) and hypocarbia, resulting in severe respiratory alkalosis during CPB and severe acidosis in the immediate postoperative period in most of the cases. Group B showed a significant reduction in the serum lactate value at CPB one hour with 3.1 mmol/l reductions, 3.8 mmol/L reductions at 2 hours and 4.4 mmol/L reductions at ICU arrival (p-value <0.0001).Serum lactate values reduced significantly in the patients with oxygen blender. Study proved that application of an oxygen blender during CPB improved the postoperative results following open-heart surgeries. The researchers conclude that using an oxygen mask was beneficial.
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