Risk factors, mechanisms and therapy for postoperative nocturnal desaturations

术后夜间血饱和度降低的危险因素、机制和治疗

基本信息

批准号：
08671714
负责人：
ISONO Shiroh
金额：
$ 1.41万
依托单位：
Chiba University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
1996
资助国家：
日本
起止时间：
1996 至 1997
项目状态：
已结题

项目摘要

Severe postoperative hypoxemia during sleep may increase the risk of postoperative cardiovascular complications. We examined risk factors and mechanisms of postoperative nocturnal desaturations, and usefulness of oxygen therapy for the treatment was evaluated. We performed overnight oximetry preoperatively and during one night between the second and fourth postoperative days in patients undergoing major surgeries. We calculated oximetry parameters such as oxygen desaturation index (ODI : h^<-1>) defined as the number of oxygen desaturations exceeding 4% below the baseline, the percentage of time spent at SpO^2<90% (CT_<90>, %), and lowest SpO^2. Postoperatively, although change of ODI was insignificant, aggravation of CT_<90> and lowest SpO^2 were significant.Multivariate analysis of possible risk factors for postoperative desaturations revealed that preoperative ODI and apnea witnessed by others were the variables highly correlated with postoperative ODI.We conclude that the presence of preoperative SDB is a significant risk factor for the development of severe postoperative desaturations during sleep.Although administration of oxygen to patients with SDB postoperatively improved nocturnal oxygenation, heart rate variability due to repeated upper airway obstructions was not eliminated. In patients with severe SDB,oxygen therapy did not eliminate events of nocturnal desaturations, and prolonged duration of apnea in some cases. This indicates that oxygen therapy may not be appropriate for the treatment of postoperative nocturnal desaturations.

睡眠期间严重的术后低氧血症可能会增加术后心血管并发症的风险。我们检查了术后夜间去饱和度的危险因素和机制，并评估了氧疗法对治疗的有用性。我们在术前进行过夜的血氧仪，并在术后第二天至第四个晚上进行了大型手术。我们计算了诸如氧饱和指数（ODI：H^<-1>）之类的血氧蛋白参数，定义为低于基线的氧气含量数量超过4％，SPO^2 <90％（CT_ <90>，％>，％）所花费的时间的百分比和最低的Spo^2。术后，尽管ODI的变化是微不足道的，但CT_ <90>和最低的Spo^2的加剧是显着的。对术后静止的可能风险因素的分析表明，术前的ODI和呼吸暂停表明，其他人见证的其他变量与术后的危险相关。睡眠过程中的饱和度。尽管术后为SDB的患者施用氧气，但尚未消除夜间氧合的夜间氧合，而由于反复的上呼吸道障碍物而导致的心率变异性。在严重的SDB患者中，氧疗法并未消除夜间饱和度的事件，在某些情况下会延长呼吸暂停持续时间。这表明氧疗法可能不适用于治疗术后夜间饱和度。