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Risk Factors for Hypoxemia After Surgery for Acute Type A Aortic Dissection

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Abstract

Purpose

Postoperative hypoxemia is a frequent complication of surgery for acute type A aortic dissection. We tried to determine the factors associated with postoperative hypoxemia.

Methods

Between 1997 and 2003, 114 patients underwent surgery for acute type A aortic dissection. Multivariate logistic regression analysis was done to identify the independent predictors of postoperative hypoxemia, defined by an arterial partial oxygen/inspired oxygen fraction (PaO2/FiO2) ratio of 200 or lower.

Results

The overall in-hospital mortality was 6.1% (7 of 114 patients), being 5.2% in the hypoxemia group and 6.9% in the non-hypoxemia group. The ventilation time and intensive care unit stay were significantly longer in the hypoxemia group than in the non-hypoxemia group (P = 0.0044, P = 0.038, respectively). Logistic regression identified the following variables as predictors for postoperative hypoxemia: body mass index ≥25 (odds ratio [OR], 5.6; 95% confidence interval [CI], 2.1–15.01; P < 0.001), preoperative PaO2/FiO2 ratio ≤300 (OR, 2.6; 95% CI, 1.09–6.13; P = 0.031), and the volume of transfused blood (OR, 1.08; 95% CI, 1.01–1.18; P = 0.037).

Conclusions

Initiating early treatment for hypoxemia and reducing the volume of blood transfused intraoperatively may improve the postoperative clinical course of obese patients with preoperative hypoxemia.

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, Iwate Medical University Memorial Heart Center, Iwate Medical University, 1-2-1 Chuodori, Morioka, 020-8505, Japan

    Takayuki Nakajima, Kohei Kawazoe, Hiroshi Izumoto & Tsuyoshi Kataoka

  2. Department of Cardiology, Iwate Medical University Memorial Heart Center, Iwate Medical University, 1-2-1 Chuodori, Morioka, 020-8505, Japan

    Hiroyuki Niinuma

  3. Department of Preventive Medicine and Environmental Health, Osaka City University, Osaka, Japan

    Nobuo Shirahashi

Authors
  1. Takayuki Nakajima
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  2. Kohei Kawazoe
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  3. Hiroshi Izumoto
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  4. Tsuyoshi Kataoka
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  5. Hiroyuki Niinuma
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  6. Nobuo Shirahashi
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Nakajima, T., Kawazoe, K., Izumoto, H. et al. Risk Factors for Hypoxemia After Surgery for Acute Type A Aortic Dissection. Surg Today 36, 680–685 (2006). https://doi.org/10.1007/s00595-006-3226-5

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  • DOI: https://doi.org/10.1007/s00595-006-3226-5

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