| Japanese |
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| Title | 成人開心術後早期抜管に関与する因子の検討 |
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| Subtitle | |
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| Authors | 山野上敬夫*, 和田誠之*, 内海兆郎*, 井上健*, 松林克典**, 世良昭彦*, 右田圭介*, 岩崎泰昌*, 福原信一*, 岡林清司*, 大谷美奈子* |
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| Authors(kana) | |
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| Organization | *広島大学医学部附属病院救急部集中治療部, **広島大学医学部附属病院手術部 |
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| Journal | 循環制御 |
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| Volume | 20 |
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| Number | 2 |
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| Page | 180-185 |
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| Year/Month | 1999/ |
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| Article | 原著 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」開心術後, 12時間以内に脈管された症例(E群;n=46)と, 12〜24時間の間に抜管された症例(I群;n=14)の術前・術中・術後ICU入室時の諸因子をretrospectiveに集計して比較し, どのような症例で早期抜管が不可能であったかを検討した. 術前因子としては, 空気呼吸下のPao2がI群において有意に低かった. 術中因子としては, I群において手術・人工心肺・大動脈遮断のそれぞれに要した時間が長く, 出血量および総水分出納が多かった. 術後因子として大量カテコラミン使用症例がI群において多く, 混合静脈血酸素飽和度がI群において低かった. 術前から肺酸素化能が低下している症例, 大きな手術侵襲を受けた症例, および術後に心機能を保つために大量カテコラミン使用を必要とする症例では, 早期抜管には慎重であるべき事が示唆された. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | 開心術, 早期抜管, 肺酸素化能, 手術侵襲, 混合静脈血酸素飽和度 |
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| English |
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| Title | Factors Affecting Duration of Postoperative Mechanical Ventilation in Cardiac Surgery Patients |
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| Authors | Takao Yamanoue*, Seishi Wada*, Yoshiro Utsumi*, Takeshi Inoue*, Katsunori Matsubayashi**, Akihiko Sera*, Keisuke Migita*, Yasumasa Iwasaki*, Shinichi Fukuhara*, Kiyoshi Okabayashi*, Minako Ohtani* |
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| Authors(kana) | |
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| Organization | *Departments of Emergency and Critical Care Medicine, Hiroshima University Hospital, **Departments of Operation Management, Hiroshima University Hospital |
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| Journal | Circulation Control |
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| Volume | 20 |
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| Number | 2 |
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| Page | 180-185 |
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| Year/Month | 1999/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | A retrospective study was conducted to clarify factors affecting the duration of postoperative mechanical ventilation in patients who underwent cardiac surgery. Sixty cardiac postoperative patients who were successfully extubated within 24 hours were studied. Forty-six patients were extubated within 12 hours (E-group), and the remaining 14 patients (I-group) were, extubated during the period between 12 and 24 postoperative hours. Preoperative Pao2 was lower (P=0.03), and the percentage of diabetic patients was higher (p=0.04) in the I-group. Longer duration of surgery (p=0.002), cardiopulmonary bypass (p=0.009), and aonic cross clamping (p=0.02) were observed in the I-group, and a greater amount of intraoperative bleeding (p=0.004) and water balance (p=0.005) were also found in the I-group. The percentage of patients who required a high dose of catecholamines was higher (p=0.02), and Svo2 was lower (p=0.01) in the I-group. These observations suggest that patients with a lower preoperative Pao2, excessive intraoperative surgical invasion, or high doses of postoperative catecholamines should not generally be extubated in the early postoperative hours. |
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| Practice | Basic medicine |
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| Keywords | Cardiac surgery, Early extubation, Pulmonary oxygenation, Surgical invasion, Mixed venous oxygen saturation |
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