CrSO<sub>2</sub>联合Pcv-aCO<sub>2</sub>对发绀型婴幼儿心脏手术后ICU停留时间的预测意义

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Abstract Objective To investigate the potential of cerebral oxygen saturation (CrSO₂) combined with central venous arterial carbon dioxide partial pressure difference (Pcv-aCO₂) to predict the length of stay in the ICU for cyanotic infants after cardiac surgery.Methods Thirty children of 0-1 year old with cyanotic congenital heart disease who underwent cardiac surgery under cardiopulmonary bypass (CPB) between June and December 2018 in the Seventh Medical Center of Chinese PLA General Hospital were selected. CrSO₂, arterial blood carbon dioxide partial pressure (PaCO₂), central venous blood carbon dioxide partial pressure (PcvCO₂)、Lac、SaO₂、Hb、MAP and T of these patients were recorded immediately after tracheal intubation and open arteriovenous (t₁), 5 minutes after ascending aortic clamping (t₂), 5 minutes after the ascending aorta was opened (t₃), at the end of CPB(t₄), 3 h after the end of CPB (t₅), 8 h after the end of CPB (t₆), 24 h after the end of CPB (t₇). Pcv-aCO₂ was calculated while postoperative length of ICU stay was recorded. The difference of perioperative Lac, CrSO₂ SaO₂、Hb、MAP、T and Pcv-aCO₂ was compared between group S (length of stay in the ICU ≤ 9 days) and group L (length of stay in the ICU>9 days). The extent to which CrSO₂ combined with Pcv-aCO₂ could help predict the length of stay in the ICU for cyanotic infants after cardiac surgery was analyzed.Results There was no significant difference in Lac between group S and group L at t₁, t₂, t₃, t₄, t₅, t₆ or t₇.Compared with group S, CrSO₂ of group L was significantly reduced at t₁, t₂, t₃, and t₄ [(53.33±4.38)% & (59.33±4.38)%, (56.83±3.51)% & (63.00±3.67)%, (47.48±5.65)% & (52.51±2.54)%, (44.58±2.42)% & (49.44±3.60)%], but there was no significant difference in CrSO₂ at t₅, t₆ and t₇.Compared with group S, Pcv-aCO₂ in group L was not significantly different at t₁, t₂, t₃, and t₄, but increased significantly at t₅, t₆, and t₇ [(16.67±5.28)mmHg & (9.63±3.98) mmHg, (21.83±6.15) mmHg & (12.71±3.10)mmHg, (13.00±2.65)mmHg & (7.36±3.03)]. There was no significant difference in PaCO₂, SaO₂, Hb, MAP and T between group S and group L at each time point.Conclusions The decrease of CrSO₂ during CPB and the increase of Pcv-aCO₂ after CPB can help predict the extension of length of stay in the ICU.

Key words： infant cardiopulmonary bypass cerebral oxygen saturction central venous arterial carbon dioxide partial pressure difference

Received: 06 March 2019

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	WEI Biyu
	LIU Yongzhe
	CHANG Yufei
	GAO Minglong

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WEI Biyu,LIU Yongzhe,CHANG Yufei等. Potential of CrSO₂ combined with Pcv-aCO₂ to predict length of stay in ICU after cardiac surgery in cyanotic infants[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2019, 30(11): 952-955.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2019/V30/I11/952

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