接受心肺搭桥术的患者按体重指数计算的常规超滤量与术后乳酸的关系

IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL
Hamid Gerami, Javad Sajedianfard, Bahram Ghasemzadeh, Maryam AnsariLari
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引用次数: 0

摘要

背景:心肺旁路术(CPB)期间的常规超滤(CUF)可最大限度地减少血液稀释。然而,大量抽吸会激活无氧糖酵解途径,导致组织灌注不足。本研究旨在确定接受冠状动脉旁路移植术(CABG)患者的体重指数 CUF 容量与乳酸之间的关系:在这项单中心回顾性研究中,共招募了641名2019-2021年间转诊至Al-Zahra医院(伊朗设拉子)并接受CPB的CABG患者。围手术期参数从患者病历中提取。结果显示,患者的平均年龄为 58.5 岁,平均射血分数为 0.5:患者的平均年龄为(58.8±11.1)岁,39.2%为女性。HL的发病率为14.5%(93名患者)。体重指数 CUF 容量与 HL 之间存在明显关联。HL患者的超滤量几乎增加了一倍(43.37±11.32 vs. 21.41±8.15 mL/Kg,PC结论:超滤量越大,术后血清乳酸水平越高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association of Weight-indexed Conventional Ultrafiltration Volume with Post-operative Lactate in Patients Undergoing Cardiopulmonary Bypass.

Background: Conventional ultrafiltration (CUF) during cardiopulmonary bypass (CPB) is utilized to minimize hemodilution. However, removing high volumes leads to tissue hypoperfusion by activating the anaerobic glycolysis pathways. This study aimed to determine the association between weight-indexed CUF volumes and lactate in patients who underwent coronary artery bypass grafting (CABG).

Methods: In this single-center retrospective study, 641 CABG patients, who were referred to Al-Zahra Hospital (Shiraz, Iran) and underwent CPB, during 2019-2021, were recruited. Peri-operative parameters were extracted from the patient's records. The patients with non-elective status, pre-existing liver and renal diseases, ejection fraction<35%, and repeated sternotomy were excluded from the study. An increase in post-operative lactate level≥4 mmol/L after 6 hours was defined as hyperlactatemia (HL). To predict HL, univariable and multiple logistic regression modeling, while controlling confounding factors, were employed.

Results: The patients' mean age was 58.8±11.1 years, and 39.2% were women. The incidence of HL was 14.5% (93 patients). There was a significant association between weight-indexed CUF volume and HL. The volume removed in the HL patients was almost doubled (43.37±11.32 vs. 21.41±8.15 mL/Kg, P<0.001), and the higher the weight-indexed CUF volume, the more likely to develop an HL at a rate of 1.38 (Odds ratio=1.38 [1.27-1.49], 95% CI, P<0.001). Furthermore, the multiple logistic regression model showed that HL was associated with the lowest mean arterial pressure (MAP) during CPB.

Conclusion: A higher volume of ultrafiltration was associated with increased post-operative serum lactate levels.

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来源期刊
Iranian Journal of Medical Sciences
Iranian Journal of Medical Sciences MEDICINE, GENERAL & INTERNAL-
CiteScore
3.20
自引率
0.00%
发文量
84
审稿时长
12 weeks
期刊介绍: The Iranian Journal of Medical Sciences (IJMS) is an international quarterly biomedical publication, which is sponsored by Shiraz University of Medical Sciences. The IJMS intends to provide a scientific medium of com­muni­cation for researchers throughout the globe. The journal welcomes original clinical articles as well as clinically oriented basic science re­search experiences on prevalent diseases in the region and analysis of various regional problems.
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