Impact Of Preoperative Hypoxemia In Patients With Debakey Type ? Aortic Dissection On Prognosis

Objective:Observe the occurrence of preoperative hypoxemia in patients with DeBakey I aortic dissection and evaluate its impact on prognosis.Methods:We conducted a retrospective analysis on the clinical data of 63 patients with acute aortic dissection undergoing operation.They were divided into two groups according to the preoperative oxygenation index(Pa02/Fi02),with Pa02/FiO2200mmHg(1mmHg=0.133KPa)being selected as hypoxemia group and Pa02/Fi02>200mmHg as non-hypoxemia group.The two groups were compared in terms of the differences in preoperative symptoms,preoperative oxygenation,and postoperative mechanical ventilation time,length of ICU stay,postoperative hospital stay,rate of re-intubation,incidence of non respiratory complications and mortality.Results:The statistical result demonstrated that the incidence of hypoxemia was 34.38%.Patients with hypoxemia have a tendency to mental disorders,and have the characteristics of less obvious subjective symptoms,relative tolerance to hypoxia.Intraoperative oxygenation becomes further deteriorating.The postoperative mechanical ventilation time,length of ICU stay,postoperative hospital stay,postoperative hypoxemia in hypoxemia group were significantly higher than those in non-hypoxemia group(P<0.05),while re-intubation rate,incidence of non respiratory complications and mortality showed no significant differences(P>0.05).Conclusions:It is concluded that hypoxemia is a common complication in patients with acute aortic dissection during perioperative period.The clinical manifestations in hypoxemia patients last and to certain extent prolong postoperative mechanical ventilation time,length of ICU stay,postoperative hospital stay,and increases the incidence of postoperative hypoxemia.It cannot be concluded that preoperative hypoxemia affects postoperative re-intubation rate,incidence of non respiratory complications and mortality at present.