Muscular tissue desaturation and pneumonia in patients receiving lung cancer surgery:a cohort study  

作　　者：Wei Zhao Caijuan Zhang Dongliang Mu Fan Cui Huiqun Jia 

机构地区：[1]Department of Anesthesiology,The Fourth Hospital of Hebei Medical University,Shijiazhuang,Hebei 050000,China [2]Department of Anesthesiology,Peking University First Hospital,Beijing 100034,China [3]Department of Anesthesiology,Tangshan Gongren Hospital,Tangshan,Hebei 063000,China

出　　处：《Chinese Medical Journal》2023年第1期65-72,共8页中华医学杂志（英文版）

基　　金：National Key R&D Program of China(No.2018YFC2001800);Project of Health Commission of Hebei Province(No.20190709)

摘　　要：Background:Post-operative pneumonia(POP)is a common complication of lung cancer surgery,and muscular tissue oxygenation is a root cause of post-operative complications.However,the association between muscular tissue desaturation and POP in patients receiving lung cancer surgery has not been specifically studied.This study aimed to investigate the potential use of intra-operative muscular tissue desaturation as a predictor of POP in patients undergoing lung cancer surgery.Methods:This cohort study enrolled patients(≥55 years)who had undergone lobectomy with one-lung ventilation.Muscular tissue oxygen saturation(SmtO_(2))was monitored in the forearm(over the brachioradialis muscle)and upper thigh(over the quadriceps)using a tissue oximeter.The minimum SmtO_(2)was the lowest intra-operative measurement at any time point.Muscular tissue desaturation was defined as a minimum baseline SmtO_(2)of<80%for>15 s.The area under or above the threshold was the product of the magnitude and time of desaturation.The primary outcome was the association between intra-operative muscular tissue desaturation and POP within seven post-operative days using multivariable logistic regression.The secondary outcome was the correlation between SmtO_(2)in the forearm and that in the thigh.Results:We enrolled 174 patients.The overall incidence of muscular desaturation(defined as SmtO_(2)<80%in the forearm at baseline)was approximately 47.1%(82/174).The patients with muscular desaturation had a higher incidence of pneumonia than those without desaturation(28.0%[23/82]vs.12.0%[11/92];P=0.008).The multivariable analysis revealed that muscular desaturation was associated with an increased risk of pneumonia(odds ratio:2.995,95%confidence interval:1.080-8.310,P=0.035)after adjusting for age,American Society of Anesthesiologists status,Assess Respiratory Risk in Surgical Patients in Catalonia score,smoking,use of peripheral nerve block,propofol,and study center.Conclusion:Muscular tissue desaturation,defined as a baseline SmtO_(2)<80%in the forearm

关 键 词：ASSOCIATION Lung neoplasms Muscular tissue oxygenation One-lung ventilation Post-operative complications PNEUMONIA PROPOFOL Oxygen saturation 

分 类 号：R730.56[医药卫生—肿瘤] R563.1[医药卫生—临床医学]