DSpace About DSpace Software 日本語
 

GINMU >
01 奈良県立医科大学 >
012 大学院 >
0122 学位請求論文 >
01221 博士論文(医学) >
2017年度 >

Please use this identifier to cite or link to this item: http://hdl.handle.net/10564/3424

Title: Impact of absence of critical respiratory rate change on oxygen desaturation following tracheal extubation after general anaesthesia: a propensity score-matched analysis.
Other Titles: 傾向スコアマッチング解析を用いた、全身麻酔術後の気管抜管後に発生する呼吸数変化を伴わない動脈血酸素飽和度低下の影響
Authors: Kawanishi, Hideaki
Inoue, Satoki
Kawaguchi, Masahiko
Keywords: respiratory rate monitoring
acoustic respiratory rate
oxygen desaturation
Issue Date: 2017
Publisher: Via Medica
Citation: Anaesthesiology intensive therapy Vol.49 No.3 p.181-188 (2017)
Abstract: BACKGROUND: It has been suggested that oxygen desaturation may be paradoxically related to the absence of an abnormal respiratory rate (RR) during acoustic respiratory rate (RRa) monitoring in a postoperative setting. We retrospectively compared the incidence of desaruration in patients without an abnormal RR with that in patients with an abnormal RR using propensity scorer matching. We also explored the factors contributing to oxygen desaturation without an RR monitoring alert. METHODS: We used ≤ 8 h postoperative data of the first 935 patients. Outcomes of patients with and without critical RR changes (RR > 30 or < 8 beats per min for > 2 min) (critical RR change vs. noncritical RR change) were first compared according to oxygen desaturation levels (SpO₂< 90% for > 10 s). Multivariate analysis was used to determine oxygen desaturation-associated explanatory factors. RESULTS: Propensity score matching yielded 259 patients without critical RR changes and 259 patients with critical RR changes, respectively. Oxygen desaturation rates were higher in patients without critical RR changes [noncritical RR change vs. critical RR change: 39/220 (15.1%) vs. 16/243 (6.2%)]. An odds ratio and 95% CI for the noncritical RR change was 2.56 (1.38-4.55, P = 0.002). A critical change in the RRa was not observed in 576 patients; of these, oxygen desaturation was observed in 76 (13.2%) patients. Surgery duration (OR, 1.018 per 10 min increase; 95% CI, 1.002 to 1.035) was independently associated with oxygen desaturation without critical RR change. CONCLUSION: Postoperative oxygen desaturation paradoxically occurred more frequently in patients without critical RR changes, whose RR was monitored by the RRa under oxygen therapy. The duration of surgery may explain the possibility of postoperative oxygen desaturation without an RRa device alert.
Description: 博士(医学)・甲第679号・平成30年3月15日
Copyright © 2017 by authors and Via Medica This work is licensed under the Creative Commons Attribution International License (CC BY-NC-ND 4.0). https://creativecommons.org/licenses/by-nc-nd/4.0/
The definitive version is available at " http://dx.doi.org/10.5603/AIT.a2017.0038 "
URI: http://hdl.handle.net/10564/3424
ISSN: 16425758
Academic Degrees and number: 24601A679
Degree-granting date: 2018-03-15
Degree name: 博士(医学)
Degree-granting institutions: 奈良県立医科大学
Appears in Collections:2017年度

Files in This Item:

File Description SizeFormat
01甲679本文の要旨.pdf甲679本文の要旨1.81 MBAdobe PDFView/Open
02甲679審査要旨.pdf甲679審査要旨386.12 kBAdobe PDFView/Open
03甲679本文.pdf甲679本文140.2 kBAdobe PDFView/Open

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

 

Valid XHTML 1.0! DSpace Software Copyright © 2002-2010  Duraspace - Feedback