Risk factors for postoperative hypoxemia in patients undergoing Stanford A aortic dissection surgery

Abstract

BackgroundThe purpose of this study is to identify the risk factors for postoperative hypoxemia in patients with Stanford A aortic dissection surgery and their relation to clinical outcomes.MethodsClinical records of 186 patients with postoperative hypoxemia in Stanford A aortic dissection were analyzed retrospectively. The patients were divided into two groups by postoperative oxygen fraction (PaO2/FiO2):hypoxemia group (N=92) and non-hypoxemia group (N=94).ResultsWe found that the incidence of postoperative hypoxemia was 49.5%. Statistical analysis by t-test and χ2 indicated that acute onset of the aortic dissection (p=0.000), preoperative oxygen fraction (PaO2/FiO2) ≤200 mmHg(p=0.000), body mass index (p=0.008), circulatory arrest (CA) time (p=0.000) and transfusion more than 3000 ml(p=0.000) were significantly associated with postoperative hypoxemia. Multiple logistic regression analysis showed that preoperative hypoxemia, CA time and transfusion more than 3000 ml were independently associated with postoperative hypoxemia in Stanford A aortic dissection.ConclusionOur results suggest that postoperative hypoxemia is a common complication in patients treated by Stanford A aortic dissection surgery. Preoperative oxygen fraction lower than 200 mmHg, longer CA time and transfusion more than 3000 ml are predictors of postoperative hypoxemia in Stanford A aortic dissection.

Predictors of Prolonged Mechanical Ventilation in Adults After Acute Type-A Aortic Dissection Repair—Implications for the Future

“…These results are similar to those published by others who have shown a variety of associated risk factors for PMV including excessive blood loss, increased age of the patient, time from symptom onset to surgery, low preoperative oxygenation, and prolonged circulatory arrest time. 11,12 The authors of the current report demonstrated a number of interesting associated risk factors including increased blood products transfused, serum lactate at conclusion of surgery, preoperative platelet count, and the oxygenation index at conclusion of surgery. They also performed propensity matching analysis, which limited the size significantly, finding 25 matched pairs, demonstrating increased mortality in the PMV group associated with excessive transfusion.…”

Preventive and therapeutic noninvasive ventilation in cardiovascular surgery

“…Wang et al [17], in a retrospective study, analyzed data on risk factors for hypoxemia (defined as PaO 2 /FiO 2 <200) after Stanford A aortic dissection. Postoperative hypoxemia was present in 49.5% of the patients.…”

Effects of pulmonary static inflation with 50% xenon on oxygen impairment during cardiopulmonary bypass for stanford type A acute aortic dissection

“…[3] The method of pulmonary static inflation with 50% xenon during CBP is easy to operate and effectively attenuates decreased OI and increased RI at the end of surgery, which may save more lives.…”