【摘 要】
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Objective To analyze the correlative risk factors of acute lung injury(ALI) /acute respiratory disorders syndrome(ARDS) in non-cardiac operation patients who received massive perioperative blood trans
【机 构】
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Department of SICU,Capital Medical University affiliated Beijing Anzhen Hospital,Beijing Institute o
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Objective To analyze the correlative risk factors of acute lung injury(ALI) /acute respiratory disorders syndrome(ARDS) in non-cardiac operation patients who received massive perioperative blood transfusion, and summarize the effect to prognoses.Methods Review the non-cardiac surgery patients in SICU from Jan.2008 to Dec.2012, there were 102 patients that total performed blood transfusion over 1500mL during perioperative period.34 cases, as group A, had progressed to ALI/ARDS, and the other 68 cases, as group B, without ALI/ARDS.Compare the gender, age, heart function, operative time, amount of intraoperative bleeding, total amount of perioperative blood products transfusion, total amount of infusion, post-operative complications, and mortality, etc., and summarize the variation tendency of oxygenation index(PaO2/FiO2) in post-operative patients from group A, discuss the independent risk factors inducing ALI/ARDS.Results Factors as operative time, total amount of transfusion, and total amount of infusion of group A are all higher than group B (P<0.05).The oxygenation index of patients from group A decrease to the lowest point on the second day after surgery (P<0.05).Comparing with Group B, patients in Group A have longer intubation time and SICU duration, and more complications like reintubation, renal failure, multiple organ dysfunction syndrome (P<0.05).Beside these, group A has higher mortality (P<0.05) , with bad prognoses.The results of logistic regression analysis shows that operative time and intraoperative infusion volume are independent risk factors inducing ARDS.Conclusion The correlative reasons of ALI/ARDS related to massive blood transfusion during perioperativeperiod of non-cardiac surgeryare operative time, total amount of perioperative blood products transfusion and total amount of infusion.Patients with ALI/ARDS have bad prognoses.Shortening operative time, decreasing the amount of blood transfusion and infusion are also considered to improve prognoses.To the ALI/ARDS tendency patients, post-operative intensive cure is the critical factor.
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