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Application of low dose aminophylline to improve oxygen metabolism and respiratory mechanics in flail chest patients with respiratory failure during operation |
Zhou Zhi-gang, Huang Fei, Yang Jin-liang, Zhang Meng, Huang Gang, Cao Li-juan |
Department of Thoracic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang 050051, China |
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Abstract Objective To investigate the effect and safety of using low-dose aminophylline to improve cerebral oxygen metabolism and respiratory mechanics in patients with flail chest combined with respiratory failure during operation. Methods In this prospective study, 46 patients with flail chest combined with respiratory failure was conducted and divided into two groups randomly. Both groups were treated by internal fixation with rib cage. The control group received conventional surgery, and the study group received intravenous injection of 0.125 g/kg aminophylline during the perioperative period. Basic surgical conditions and complications were recorded. The respiratory mechanical indexes such as peak airway pressure, airway platform pressure, airway resistance, and lung compliance, the cerebral oxygen metabolism indexes such as venous oxygen saturation (SjvO2), arteriovenous oxygen content difference (a-vDO2), and cerebral oxygen metabolism rate (CMRO2) before the use of aminophylline and at 10 min, 30 min and 60 min after the use of aminophylline were compared respectively. Results There was no significant differences between the two groups in operation time, intraoperative blood loss, drainage tube indwelling time and hospitalization time (P>0.05). There was no significant difference in the incidence of intraoperative and postoperative complications too (P>0.05).Before the application of aminophylline, there was no significant difference in respiratory mechanics and cerebral oxygen metabolism between the two groups (P>0.05). After theophylline was applied, there was no significant change in each index in the control group (P>0.05), while the peak airway pressure, airway platform pressure, and airway resistance in the study group were all decreased, the lung compliance and CMRO2 in the study group were both increased, and there was statistical significance at any time point compared with before treatment and with the control group (P<0.05). Conclusion Small dose aminophylline could improve cerebral oxygen metabolism and respiratory mechanics in patients with flail chest combined with respiratory failure, which has high clinical value.
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About author:: Zhou Zhi-gang, E-mail: 1205888646@qq.com |
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[1]Perera TB, Daley BJ. Flail Chest [M]. StatPearls. Treasure Island (FL): 2019: 5-16.
[2]Liu X, Xiong K. Surgical management versus non-surgical management of rib fractures in chest trauma:a systematic review and meta-analysis [J]. J Cardiothorac Surg, 2019, 14(1): 45.
[3]Ingoe HM, Coleman E, Eardley W, et al. Systematic review of systematic reviews for effectiveness of internal fixation for flail chest and rib fractures in adults[J]. BMJ Open, 2019, 9(4): e023444.
[4]周一凡, 龙小毛, 刘松涛, 等. 氨茶碱在肺叶切除术中肺保护作用的临床研究[J]. 北京医学, 2015, 37(2): 165-166.
[5]Du D. Advances in the Management of Thoracic Trauma[M]. 2017: 23-46.
[6]Divisi D, Barone M, Crisci R. Surgical management of flail chest: state of art and future perspectives [J]. Curr Surg Rep, 2017, 5(9): 21.
[7]Azhar N. Pre-operative optimisation of lung function [J]. Indian J Anaesth, 2015, 59(9): 550-556.
[8]崔晓岗,冉红,王永宏,等. 氨茶碱对七氟醚麻醉下罗库溴铵肌松恢复的影响[J]. 实用医学杂志, 2018, 34(19): 3273-3276.
[9]Shahbazi S, Alishahi P, Asadpour E. Evaluation of the effect of aminophylline in reducing the incidence of acute kidney injury after cardiac surgery[J]. Anesth Pain Med, 2017, 7(4): e21740.
[10]王应琼, 石慧芳, 何海武, 等. 跨肺压指导下机械通气对急性呼吸窘迫综合征患者呼吸功能和血液动力学的影响[J]. 内科急危重症杂志, 2018, 24(5): 359-363.
[11]王赶云. 多索茶碱与氨茶碱治疗支气管哮喘临床疗效比较[J]. 临床合理用药杂志, 2019, 12(7): 50-51.
[12]香松林, 高奇, 寿志南, 等. 慢性阻塞性肺疾病急性加重期不同剂量氨茶碱疗效、不良反应观察[J]. 中国医院药学杂志, 2017, 37(6): 526-529.
[13]Shen CM. Aminophylline therapy and the neurodevelopment in premature infants[J]. Pediatr Neonatol, 2016, 57(1): 3-4.
[14]Kim DW, Joo JD, In JH, et al. Comparison of the recovery and respiratory effects of aminophylline and doxapram following total intravenous anesthesia with propofol and remifentanil[J]. J Clin Anesth, 2013, 25(3): 173-176.
[15]Ali A, Ozsoy O, Basaran B, et al. The effects of atropine and aminophylline premedication on respiratory problems after electroconvulsive therapy: a prospective, randomized, crossover trial[J]. Bulletin of Clinical Psychopharmacology, 2015, 25(4): 1.
[16]Yang CJ, Chen T, Ni X, et al. Effect of pre-administration with aminophylline on the occurrence of post-dural puncture headache in women undergoing caesarean section by combined spinal-epidural anaesthesia[J]. J Int Med Res, 2019, 47(1): 420-426. |
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