Eur Respir J:睡眠呼吸紊乱患者心脏手术后谵妄的预测因素

2019-08-15 xing.T MedSci原创

在已知的谵妄危险因素中,中枢性睡眠呼吸暂停与谵妄独立相关。该研究的结果有助于确定患有术后谵妄的高风险患者,这些患者可能从强化的谵妄预防策略中受益。

谵妄是心脏手术后最​​常见的并发症之一。虽然已经确定了各种危险因素,但迄今为止,睡眠呼吸紊乱(SDB)和谵妄之间的关联几乎没有被研究过。近日,呼吸疾病领域权威杂志Eur Respir J上发表了一篇研究文章,研究人员的目的是明确术后谵妄的发生率,并确定有和没有SDB的患者谵妄的危险因素。

研究人员对正在进行的前瞻性观察研究CONSIDER-AF(ClinicalTrials.gov标识符NCT02877745)进行亚组分析评估了141名接受心脏手术的患者谵妄的危险因素。在手术前一晚用便携式SDB监测仪评估SDB的存在情况和类型。在拔管当天使用经验证的重症监护室混淆评估方法对谵妄进行前瞻性评估,最多3天。

23%的患者被诊断为谵妄:16%的患者没有SDB,13%患有阻塞性睡眠呼吸暂停,49%患有中枢性睡眠呼吸暂停。多变量logistic回归分析显示,谵妄与年龄≥70岁(OR为5.63,95%CI为1.79-17.68; p=0.003)、中枢性睡眠呼吸暂停(OR为4.99,95%CI为1.41-17.69; p=0.013)和心力衰竭(OR为3.3,95%CI为1.06-10.35; p=0.039)独立相关。谵妄患者的住院时间和在重症监护室花费的时间明显更长。

在已知的谵妄危险因素中,中枢性睡眠呼吸暂停与谵妄独立相关。该研究的结果有助于确定患有术后谵妄的高风险患者,这些患者可能从强化的谵妄预防策略中受益。 

原始出处:

Maria Tafelmeier.Predictors of delirium after cardiac surgery in patients with sleep disordered breathing.Eur Respir J.2019.https://erj.ersjournals.com/content/54/2/1900354

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    2019-08-16 1ddf0692m34(暂无匿称)

    学习了,谢谢分享

    0

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    2019-08-15 一个字-牛

    学习了谢谢分享

    0

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