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Analysis of the risk factors of postoperative respiratory dysfunction of type A aortic dissection and lung protection.
MedLine Citation:
PMID:  19767332     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
AIM: Retrospectively to analyze the risk factors of postoperative respiratory dysfunction (RD) in 196 patients with type A dissection operated on with cerebral perfusion and a lower body hypothermia circulatory arrest (HCA) and to investigate the method of the lung protection. METHODS: From January 2005 to April 2008, 196 patients with type A dissection underwent surgical repair with cerebral perfusion and HCA. There were 142 male patients and 54 female patients, with ages from 17 to 78 years. Antegrade selective cerebral perfusion (SCP) through the axillary artery was performed for 168 patients and retrograde cerebral perfusion (RCP) from the superior vena cava for 28 patients. All the factors underwent univariate and multivariate analysis. RESULTS: Mean cardiopulmonary bypass (CPB) duration was (186+/-56) minutes and mean cerebral perfusion time was (35+/-15) minutes; mean HCA time was (39+/-14) minutes. Postoperative RD was detected in 26 patients (13.3%). Multivariate analysis showed that the longer duration of circulatory arrest (CA), P=0.008, OR=1.048, and the higher temperature in the bladder during CA, P=0.002, OR=1.614, were independent risk factors of postoperative RD. There was a higher mortality (23.1%, P=0.025) in patients with postoperative RD when compared with the other patients. CONCLUSION: The longer duration of CA and the higher temperature in the bladder during CA were found to be the independent risk factors of postoperative RD after type A aortic dissection surgery. Attention should be paid to lung protection for these patients and the adjunct of continuing descending aortic perfusion and cerebral perfusion should be a safe and feasible procedure and it would be valuable to perform a prospective trial.
Authors:
Hai-Yan Luo; Ke-Jian Hu; Jin-Yuan Zhou; Chun-Sheng Wang
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-09-18
Journal Detail:
Title:  Perfusion     Volume:  24     ISSN:  1477-111X     ISO Abbreviation:  Perfusion     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-11-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8700166     Medline TA:  Perfusion     Country:  England    
Other Details:
Languages:  eng     Pagination:  199-202     Citation Subset:  IM    
Affiliation:
Zhong Shan Hospital, Fu Dan University, Shang Hai, 20032, China.
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