Original Article
Risk factors for postoperative hypoxemia in patients undergoing Stanford type A aortic dissection surgery
Lin Lizhu, Liang Beiwei, Liang Dongke, Lu Yizhi, Zhang Bingdong
Published 2018-01-05
Cite as Chin J Postgrad Med, 2018,41(1): 25-29. DOI: 10.3760/cma.j.issn.1673-4904.2018.01.007
Abstract
ObjectiveTo explore the risk factors for postoperative hypoxemia in patients undergoing Stanford type A aortic dissection surgery.
MethodsThe clinical data of 77 patients with Stanford type A aortic dissection surgery were analyzed retrospectively. Among the patients, 40 patients occurred hypoxemia (hypoxemia group), and 37 patients did not occur hypoxemia (non- hypoxemia group). The preoperative, intraoperative and postoperative clinical data were compared between 2 groups, and the independent risk factors for postoperative hypoxemia were analyzed by multiple Logistic regression analysis.
ResultsThe incidence of postoperative hypoxemia in patients with Stanford type A aortic dissection was 51.9% (40/77). The multiple Logistic regression analysis result showed that age (OR= 1.088, 95% CI 1.018-1.164, P= 0.013), body mass index ≥ 25 kg/m2 (OR= 6.495, 95% CI 1.327- 31.789, P= 0.021), pericardial effusion (OR= 6.384, 95% CI 1.426-28.576, P= 0.015), white blood cell count (OR= 1.289, 95% CI 1.033-1.609, P= 0.024) and using recombinant human coagulation Ⅶ a (OR= 23.757, 95% CI 2.849-198.085, P= 0.003) were the independent predictive factors for postoperative hypoxemia in patients with Stanford type A aortic dissection.
ConclusionsThe postoperative hypoxemia in patients with Stanford type A aortic dissection is related with perioperative systemic inflammation, especially in obese patients who should be given anti- inflammatory treatment during perioperative period. Control of bleeding and reducing the recombinant human coagulation Ⅶa as far as possible can reduce the incidence of postoperative hypoxemia.
Key words:
Aortic diseases; Anoxia; Risk factors; Retrospective studies
Contributor Information
Lin Lizhu
Department of Anesthesia, Institute of Cardiovascular Diseases, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
Liang Beiwei
Liang Dongke
Lu Yizhi
Zhang Bingdong