Relative Factors Of Postoperative Hypoxemia In Patients After Coronary Artery Bypass Gafting Surgery

Objective Coronary artery bypasses grafting can be seen as a main treatment of coronary heart disease,which has been conducted widely in the countryside.However,the rate of postoperative hypoxemia is increasing,which affect the quality of treatment and prognosis.In this research,we analyzed many factors of patients with CABG in our department in order to find out the relative risk factors of postoperative hypoxemia after CABG to decrease the rate of hypoxemia after CABG and provide effective treatment to patient who has already got hypoxemia.Methods Seventy two patients who received the treatment of CABG from January 2014 to December 2017 in our hospital are selected to conduct a retrospective analysis about a series of relative risk factors during their perioperative period.Under the condition of mechanical ventilation(Fi O2 over 45%)or mask with nasal catheter for oxygen supply(over 6 L/min)after CABG,any PaO2 less than [102-(0.33 X age)]mm Hg could be seem as postoperative hypoxemia.Meanwhile,recording the following relative risk factors including age,gender,body mass index(BMI),smoking history,acute myocardial infarction history,hypertension history,diabetes mellitus,preoperative left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter,duration of surgery,intraoperative application of extracorporeal circulation,the number of bypass,intraoperative blood loss,intraoperative rehydration,preoperative hemoglobin,postoperative hemoglobin,preoperative PaO2 to comfirm the relationship by statistic analysis.Results Of the 72 CABG patients,20 patients(27.8%)had hypoxemia after CABG.Through the single factor analysis,ten relative risk factors:smoking history,diabetes mellitus,acute myocardial infarction history,preoperative left ventricular ejection fraction,intraoperative application of extracorporeal circulation,age,body mass index,intraoperative blood loss,intraoperative infusion volume,time of surgery,are related to the occurrence of postoperative hypoxemia(P < 0.05).Multiariable logistic regression analysis showes that smoking history,age,preoperative left ventricular ejection fraction,body mass index,intraoperative application of extracorporeal circulation are significantly associated with the incidence of postoperative hypoxemia(P < 0.05),which can be treated as independent risk factors.According to various risk factors analysis,the effective prevention and measures can be used in the perioperative period.Conclusion Smoking,diabetes mellitus,acute myocardial infarction history,left ventricular ejection fraction preoperatively,intraoperative application of extracorporeal circulation,age,body mass index,intraoperative blood loss,intraoperative infusion volume,duration of surgery are associated with the incidence of postoperative hypoxemia,moreover,smoking history,age,preoperative left ventricular ejection fraction,body mass index,intraoperative application of extracorporeal circulation during the surgery are the independent risk factors for postoperative hypoxemia.