کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2759174 1150149 2014 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Impact of Perioperative Blood Pressure Variability on Health Resource Utilization After Cardiac Surgery: An Analysis of the ECLIPSE Trials
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیهوشی و پزشکی درد
پیش نمایش صفحه اول مقاله
Impact of Perioperative Blood Pressure Variability on Health Resource Utilization After Cardiac Surgery: An Analysis of the ECLIPSE Trials
چکیده انگلیسی

ObjectiveTo examine the impact of blood pressure control on hospital health resource utilization using data from the ECLIPSE trials.DesignPost-hoc analysis of data from 3 prospective, open-label, randomized clinical trials (ECLIPSE trials).SettingSixty-one medical centers in the United States.ParticipantsPatients 18 years or older undergoing cardiac surgery.InterventionsClevidipine was compared with nitroglycerin, sodium nitroprusside, and nicardipine.Measurements and Main ResultsThe ECLIPSE trials included 3 individual randomized open-label studies comparing clevidipine to nitroglycerin, sodium nitroprusside, and nicardipine. Blood pressure control was assessed as the integral of the cumulative area under the curve (AUC) outside specified systolic blood pressure ranges, such that lower AUC represents less variability. This analysis examined surgery duration, time to extubation, as well as intensive care unit (ICU) and hospital length of stay (LOS) in patients with AUC≤10 mmHg×min/h compared to patients with AUC>10 mmHg×min/h. One thousand four hundred ten patients were included for analysis; 736 patients (52%) had an AUC≤10 mmHg×min/h, and 674 (48%) had an AUC>10 mmHg×min/h. The duration of surgery and ICU LOS were similar between groups. Time to extubation and postoperative LOS were both significantly shorter (p = 0.05 and p<0.0001, respectively) in patients with AUC≤10. Multivariate analysis demonstrates AUC≤10 was significantly and independently associated with decreased time to extubation (hazard ratio 1.132, p = 0.0261) and postoperative LOS (hazard ratio 1.221, p = 0.0006).ConclusionsBased on data derived from the ECLIPSE studies, increased perioperative BP variability is associated with delayed time to extubation and increased postoperative LOS.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Cardiothoracic and Vascular Anesthesia - Volume 28, Issue 3, June 2014, Pages 579–585
نویسندگان
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