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

• Material Type: 博士論文
• Title: Impact of absence of critical respiratory rate change on oxygen desaturation following tracheal extubation after general anaesthesia: a propensity score-matched analysis.
• Author/Editor: Kawanishi, Hideaki; Inoue, Satoki; Kawaguchi, Masahiko
• Author Heading: Kawanishi, Hideaki; Inoue, Satoki; Kawaguchi, Masahiko
• Publication, Distribution, etc.: Via Medica
• Publication Date: 2017
• Publication Date (W3CDTF): 2017
• Alternative Title: 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
• Periodical title: Anaesthesiology intensive therapy
• No. or year of volume/issue: 49 3
• Volume: 49
• Issue: 3
• Pages: 181-188
• ISSN (Periodical Title): ISSN : 1642-5758
• Degree grantor/type: 奈良県立医科大学
• Date Granted: 2018-03-15
• Dissertation Number: 甲第679号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: respiratory rate monitoring; acoustic respiratory rate; oxygen desaturation
• Target Audience: 一般
• Note (General): 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
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.5603/AIT.a2017.0038
• Data Provider (Database): 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
• Original Data Provider (Database): 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

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