机械通气下接受骨科手术的患者，术中机械功率是否与术后氧合受损和肺部并发症相关？这是麻醉医生在围术期呼吸管理中可能遇到的一个实际问题。下面这篇文献将围绕这一问题提供新的证据。
文献英文标题
Mechanical Power and the Association with Postoperative Impaired Oxygenation and Pulmonary Complications in Orthopedic Patients: Post Hoc Analysis of a Cluster Factorial Randomized Trial.
英文摘要要点
Background: Mechanical power refers to the energy transferred from the ventilator to the respiratory system per unit time and has been proposed as an integrated indicator of ventilator-related harm.
Methods: This study was a post hoc analysis of a cluster factorial randomized trial. Patients undergoing orthopedic surgery were assigned to different intraoperative ventilation strategies using tidal volumes of 6 or 10 ml/kg predicted body weight and PEEP of 5 or 8 cmH₂O, resulting in a range of exposure to intraoperative mechanical power.
Results: The analysis included 2860 surgeries in 2582 patients. Higher intraoperative mechanical power normalized to predicted body weight was associated with worse postoperative oxygenation in the postanesthesia care unit and on the ward, and with increased odds of postoperative pulmonary complications.
Conclusions: Higher intraoperative mechanical power was associated with postoperative impaired oxygenation and pulmonary complications in orthopedic surgical patients. Driving pressure showed a comparable strength of association with postoperative oxygenation.
文献标题中文翻译
骨科患者中机械功率与术后氧合受损及肺部并发症的关系：一项整群析因随机试验的事后分析
一、文献简介 / Introduction
机械功率是指呼吸机在单位时间内传递给呼吸系统的能量。与潮气量、PEEP、驱动压或呼吸频率等单一参数不同，机械功率试图把多个通气参数整合起来，用于反映机械通气对肺组织可能造成的总体能量负荷。
在重症医学和机械通气相关肺损伤研究中，机械功率已经受到越来越多关注。但在手术室内，尤其是在接受全身麻醉和机械通气的骨科手术患者中，术中机械功率是否与术后氧合受损和肺部并发症相关，仍是一个值得进一步探讨的问题。
这项发表于 Anesthesiology 的研究，正是基于一项整群析因随机试验数据进行的事后分析，旨在评估术中机械功率与术后氧合、术后肺部并发症以及住院时间之间的关系。