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Effects of controlled hypotension with restrictive transfusion on intraoperative blood loss and systemic oxygen metabolism in elderly patients who underwent lumbar fusion.

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  • المؤلفون: Qiu X;Qiu X; Tan Z; Tan Z; Tang W; Tang W; Ye H; Ye H; Lu X; Lu X
  • المصدر:
    Trials [Trials] 2021 Jan 28; Vol. 22 (1), pp. 99. Date of Electronic Publication: 2021 Jan 28.
  • نوع النشر :
    Journal Article; Randomized Controlled Trial
  • اللغة:
    English
  • معلومة اضافية
    • المصدر:
      Publisher: BioMed Central Country of Publication: England NLM ID: 101263253 Publication Model: Electronic Cited Medium: Internet ISSN: 1745-6215 (Electronic) Linking ISSN: 17456215 NLM ISO Abbreviation: Trials Subsets: MEDLINE
    • بيانات النشر:
      Original Publication: [London] : BioMed Central, 2006-
    • الموضوع:
      Blood Transfusion/*methods ; Hypotension, Controlled/*methods ; Intervertebral Disc Degeneration/*surgery ; Spinal Fusion/*adverse effects; Administration, Intravenous ; Aged ; Blood Loss, Surgical/prevention & control ; Blood Loss, Surgical/statistics & numerical data ; Blood Pressure/drug effects ; Blood Pressure/physiology ; Blood Transfusion/statistics & numerical data ; Female ; Glomerular Filtration Rate/physiology ; Humans ; Hypotension, Controlled/adverse effects ; Kidney/physiology ; Lumbar Vertebrae/surgery ; Male ; Middle Aged ; Nitroglycerin/administration & dosage ; Nitroglycerin/adverse effects ; Oxygen/blood ; Oxygen/metabolism ; Treatment Outcome
    • نبذة مختصرة :
      Background: The effects of restrictive fluid therapy combined with controlled hypotension in the elderly on systemic oxygen metabolism and renal function are clinical concerns. The aim of this study was to evaluate blood loss, oxygen metabolism, and renal function in different levels of controlled hypotension induced by intravenous nitroglycerin, in combination with limited infusion, in elderly patients undergoing posterior lumbar fusion.
      Methods: A total of 40 patients, aged 60-75 with ASA grade II or III, who were planned for posterior lumbar fusion were randomly allocated into two groups: experimental group [target mean arterial pressure 65 mmHg (MAP 65) or control group (MAP 75)]. Indicators for blood loss, hemodynamic, systemic oxygen metabolism, and renal function evaluation index were recorded before operation (T0), 1 h after induced hypotension (T1), 2 h after hypotension (T2), and in recovery (T3). We compared changes in these parameters between groups to evaluate the combined effects of controlled hypotension with restrictive infusion.
      Results: CI, DO 2 I, and VO 2 I were lower in both groups at T1-T3 compared with T0 (p < 0.05). DO 2 I and VO 2 I in the MAP 65 group were lower than the MAP 75 group after operation. In both groups, SCysC increased at T1, T2, and T3 (p < 0.05) compared with T0.
      Conclusions: Restrictive transfusion and control MAP at 65 mmHg can slightly change in renal function and reduce the risk of insufficient oxygen supply and importantly have no significant effect on blood loss and postoperative complications.
      Trial Registration: ChiCTR-INR-16008153 . Registered on 25 March 2016.
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    • Contributed Indexing:
      Keywords: Controlled hypotension; Renal function; Restrictive transfusion; Systemic oxygen metabolism
    • الرقم المعرف:
      G59M7S0WS3 (Nitroglycerin)
      S88TT14065 (Oxygen)
    • الموضوع:
      Date Created: 20210129 Date Completed: 20210208 Latest Revision: 20210208
    • الموضوع:
      20250114
    • الرقم المعرف:
      PMC7841987
    • الرقم المعرف:
      10.1186/s13063-020-05015-5
    • الرقم المعرف:
      33509270