Hospital stay and mortality are increased in patients having a triple low of low blood pressure, low bispectral index, and low minimum alveolar concentration of volatile anesthesia

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1、PERIOPERATIVEMEDICINEHospitalStayandMortalityAreIncreasedinPatientsHavinga“TripleLow”ofLowBloodPressure,LowBispectralIndex,andLowMinimumAlveolarConcentrationofVolatileAnesthesiaDanielI.Sessler,M.D.,*JeffreyC.Sigl,Ph.D.,†ScottD.Kelley,M.D.,‡NassibG.Chamoun,M.S.,§PaulJ.M

2、anberg,Ph.D.,
LeifSaager,M.D.,#AndreaKurz,M.D.,**ScottGreenwald,Ph.D.††ABSTRACTWhatWeAlreadyKnowaboutThisTopic·AnesthesiologistscontinuetorefinefactorsassociatedwithBackground:Lowmeanarterialpressure(MAP)anddeepmorbidityandmortalityaftersurgery.hypnosishavebeenassociat

3、edwithcomplicationsandmor-·Itishopedidentificationofsuchfactorswillleadtotreatmentstality.Thenormalresponsetohighminimumalveolarcon-thatmaygreatlyreduceadverseoutcomesduringtheperiop-erativeperiod.centration(MAC)fractionofanestheticsishypotensionandlowBispectralIndex(B

4、IS)scores.LowMAPand/orBISatlowerMACfractionsmayrepresentanestheticsensitivity.TheauthorssoughttocharacterizetheeffectofthetriplelowWhatThisArticleTellsUsThatIsNewstate(lowMAPandlowBISduringalowMACfraction)on·Inthisretrospectivereviewofalargedatabasefromasingledurationo

5、fhospitalizationand30-dayall-causemortality.institution,theoccurrenceoflowmeanarterialpressureduringMethods:MeanintraoperativeMAP,BIS,andMACwerelowminimumalveolarconcentrationfractionwasastrongandhighlysignificantpredictorformortality,andwhencombineddeterminedfor24,120

6、noncardiacsurgerypatientsatthewithlowbispectralindex,themortalityriskwasevengreater.ClevelandClinic,Cleveland,Ohio.Thehazardratiosasso-AdditionalstudiesareneededtovalidatethetriplelowasanciatedwithcombinationsofMAP,BIS,andMACvaluesindicatorofperioperativemortality.*Mic

7、haelCudahyProfessorandChair,#AssistantProfessor,greaterorlessthanareferencevalueweredetermined.The**ProfessorandVice-chair,DepartmentofOUTCOMESRESEARCH,ClevelandClinic,Cleveland,Ohio.†Director,AnalyticalResearch,authorsalsoevaluatedtheassociationbetweencumulative‡Chief

8、MedicalOfficer,RespiratoryandMonitoringSolutions,triplelowminutes,andexcesslength-of-stayand30-day††SeniorDirector,Ad