优化脑氧饱和度对接受单肺通气胸腔镜手术的老年患者术后谵妄的影响

IF 1.4 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL
Peilan Teng, Henghua Liu, Derong Xu, Xuexin Feng, Miao Liu, Qingxiu Wang
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引用次数: 0

摘要

目的这项随机对照试验研究了区域脑氧饱和度(rScO2)引导的肺保护性通气策略能否改善65岁以上患者的脑氧并降低术后谵妄(POD)的发生率。方法这项随机对照试验纳入了120名接受单肺通气(OLV)的胸外科手术患者。患者被随机分配到肺保护通气组(PV 组)或以 rScO2 为导向的肺保护通气组(TPV 组)。术中记录 rScO2,并评估 POD 的发生情况。结果术后 3 天 POD 的发生率(主要结果)在 TPV 组显著降低(23.3% 对 8.5%)。同时,与 POD 相关的生物学指标(S100β、神经元特异性烯醇化酶、肿瘤坏死因子-α)水平在 TPV 组较低。在次要结果方面,OLV 组和 TPV 组的氧合指数均较低,而 TPV 组的二氧化碳分压和平均动脉压明显升高。此外,TPV 组术中最小 rScO2 和平均 rScO2 均高于 PV 组。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effect of optimizing cerebral oxygen saturation on postoperative delirium in older patients undergoing one-lung ventilation for thoracoscopic surgery
ObjectivesThis randomized controlled trial investigated whether the regional cerebral oxygenation saturation (rScO2)-guided lung-protective ventilation strategy could improve brain oxygen and reduce the incidence of postoperative delirium (POD) in patients older than 65 years.MethodsThis randomized controlled trial enrolled 120 patients undergoing thoracic surgery who received one-lung ventilation (OLV). Patients were randomly assigned to the lung-protective ventilation group (PV group) or rScO2-oriented lung-protective ventilation group (TPV group). rScO2 was recorded during the surgery, and the occurrence of POD was assessed.ResultsThe incidence of POD 3 days after surgery—the primary outcome—was significantly lower in the TPV group (23.3% versus 8.5%). Meanwhile, the levels of POD-related biological indicators (S100β, neuron-specific enolase, tumor necrosis factor-α) were lower in the TPV group. Considering the secondary outcomes, both groups exhibited a lower oxygenation index after OLV, whereas partial pressure of carbon dioxide and mean arterial pressure were significantly increased in the TPV group. In addition, minimum rScO2 during surgery and mean rScO2 were higher in the TPV group than in the PV group.ConclusionContinuous intraoperative monitoring of brain tissue oxygenation and active intervention measures guided by cerebral oxygen saturation are critical for improving brain metabolism and reducing the risk of POD.
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来源期刊
CiteScore
3.20
自引率
0.00%
发文量
555
审稿时长
1 months
期刊介绍: _Journal of International Medical Research_ is a leading international journal for rapid publication of original medical, pre-clinical and clinical research, reviews, preliminary and pilot studies on a page charge basis. As a service to authors, every article accepted by peer review will be given a full technical edit to make papers as accessible and readable to the international medical community as rapidly as possible. Once the technical edit queries have been answered to the satisfaction of the journal, the paper will be published and made available freely to everyone under a creative commons licence. Symposium proceedings, summaries of presentations or collections of medical, pre-clinical or clinical data on a specific topic are welcome for publication as supplements. Print ISSN: 0300-0605
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