心脏手术结果中的中和后活化凝血时间和术后输血。

Muhammad Arslan Zahid, Syed Shabbir Ahmed, Muhammad Saad Yousuf, Sadique Ali Wadho, Muhammad Irfan Akhtar, Mohammad Hamid
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引用次数: 0

摘要

目的:评估前列腺素中和后活化凝血时间(ACT)值对心脏手术患者术后结果的影响,包括胸腔引流管输出量、输血需求和重症监护病房住院时间:评估接受心脏手术的患者在氯胺酮中和后活化凝血时间(ACT)值对术后结果(包括胸腔引流管排出量、输血需求和重症监护病房住院时间)的影响:观察比较研究。研究地点和时间:巴基斯坦卡拉奇阿迦汗大学医院麻醉科,2023 年 2 月至 8 月:从择期心脏手术患者的病历中收集数据已获得伦理批准。采用顺序抽样法分析了基线和前列腺素中和后的 ACT 值,将患者分为两组。A 组患者的 ACT 值保持在基线值的 10%以内,B 组患者的 ACT 值偏离基线值。测量的结果包括输血需求、胸腔引流管排出量、额外的质胺、心脏重症监护室(CICU)住院时间和术后再次开胸。统计分析包括平均值、中位数、频率、t 检验/曼-惠特尼 U 检验和卡方检验:研究对象包括 101 名患者(A 组 39 人,B 组 62 人),他们的基线健康状况相似。两组患者在氨甲环酸使用量、重症监护室住院时间、胸腔引流管排出量和输血率方面无明显差异(P>0.05):结论:将原胺中和后的ACT维持在基线的10%以内可获得相似的术中和术后结果,这表明在心脏手术中避免积极的原胺治疗和确保止血具有潜在的益处:关键词: 冠状动脉旁路移植术、心肺旁路、活化凝血时间(ACT)、肝素、术后出血、输血。
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Post-Neutralisation Activated Clotting Time and Postoperative Transfusions in Cardiac Surgery Outcome.

Objective: To assess the impact of post-protamine neutralisation activated clotting time (ACT) values on postoperative outcomes including chest drain output, transfusion requirements, and CICU stay, in patients undergoing cardiac surgery.

Study design: Observational comparative study. Place and Duration of the Study: Department of Anaesthesiology, The Aga Khan University Hospital, Karachi, Pakistan, from February to August 2023.

Methodology: Ethical approval was obtained to collect data from elective cardiac surgery patients' charts. A sequential sampling approach analysed the baseline and post-protamine neutralisation ACT values, categorising patients into two groups. Group A maintained ACT within 10% of baseline, while Group B deviated. The outcomes measured included transfusion needs, chest drain output, additional protamine, cardiac intensive care unit (CICU) stay, and postoperative reopening. Statistical analysis included mean, median, frequency, t-test / Mann-Whitney U test, and Chi-square test.

Results: The study comprised 101 patients (39 in Group A, 62 in Group B), with similar baseline health. No significant differences were found in tranexamic acid use, CICU stay, chest drain output, or transfusion rates between the groups (p >0.05).

Conclusion: Maintaining ACT within 10% of baseline post-protamine neutralisation results in similar intraoperative and postoperative outcomes, suggesting potential benefits in avoiding the aggressive protamine therapy and ensuring haemostasis in cardiac surgery.

Key words: Coronary Artery bypass grafting, Cardiopulmonary bypass, Activated clotting time (ACT), Heparin, Postoperative bleeding, Blood transfusions.

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