Impact of absence of critical respiratory rate change on oxygen desaturation following tracheal extubation after general anaesthesia: a propensity score-matched analysis.

• 資料種別: 博士論文
• タイトル: Impact of absence of critical respiratory rate change on oxygen desaturation following tracheal extubation after general anaesthesia: a propensity score-matched analysis.
• 著者・編者: Kawanishi, Hideaki; Inoue, Satoki; Kawaguchi, Masahiko
• 著者標目: Kawanishi, Hideaki; Inoue, Satoki; Kawaguchi, Masahiko
• 出版事項: Via Medica
• 出版年月日等: 2017
• 出版年（W3CDTF）: 2017
• 並列タイトル等: 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
• タイトル（掲載誌）: Anaesthesiology intensive therapy
• 巻号年月日等（掲載誌）: 49 3
• 掲載巻: 49
• 掲載号: 3
• 掲載ページ: 181-188
• ISSN（掲載誌）: ISSN : 1642-5758
• 授与機関名: 奈良県立医科大学
• 授与年月日: 2018-03-15
• 報告番号: 甲第679号
• 学位: 博士（医学）
• 本文の言語コード: eng
• 件名標目: respiratory rate monitoring; acoustic respiratory rate; oxygen desaturation
• 対象利用者: 一般
• 一般注記: type:Thesis; 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.; 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 "; identifier:Anaesthesiology intensive therapy Vol.49 No.3 p.181-188 (2017); identifier:16425758; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3424; identifier:Anaesthesiology intensive therapy, 49(3): 181-188
• オンライン閲覧公開範囲: インターネット公開
• 関連情報（DOI）: 10.5603/AIT.a2017.0038
• 連携機関・データベース: 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• 提供元機関・データベース: 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU

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http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3424/1/01%e7%94%b2679%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3424/2/02%e7%94%b2679%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3424/3/03%e7%94%b2679%e6%9c%ac%e6%96%87.pdf fulltext