Muscular tissue desaturation and pneumonia in patients receiving lung cancer surgery:a cohort study

作     者：Wei Zhao Caijuan Zhang Dongliang Mu Fan Cui Huiqun Jia 

作者机构：Department of AnesthesiologyThe Fourth Hospital of Hebei Medical UniversityShijiazhuangHebei 050000China Department of AnesthesiologyPeking University First HospitalBeijing 100034China Department of AnesthesiologyTangshan Gongren HospitalTangshanHebei 063000China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2023年第136卷第1期

页      面：65-72页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：National Key R&D Program of China(No.2018YFC2001800) Project of Health Commission of Hebei Province(No.20190709) 

主　　题：Association Lung neoplasms Muscular tissue oxygenation One-lung ventilation Post-operative complications Pneumonia Propofol Oxygen saturation 

摘      要：Background:Post-operative pneumonia(POP)is a common complication of lung cancer surgery,and muscular tissue oxygenation is a root cause of post-operative complications.However,the association between muscular tissue desaturation and POP in patients receiving lung cancer surgery has not been specifically studied.This study aimed to investigate the potential use of intra-operative muscular tissue desaturation as a predictor of POP in patients undergoing lung cancer surgery.Methods:This cohort study enrolled patients(≥55 years)who had undergone lobectomy with one-lung ventilation.Muscular tissue oxygen saturation(SmtO_(2))was monitored in the forearm(over the brachioradialis muscle)and upper thigh(over the quadriceps)using a tissue oximeter.The minimum SmtO_(2)was the lowest intra-operative measurement at any time point.Muscular tissue desaturation was defined as a minimum baseline SmtO_(2)of15 s.The area under or above the threshold was the product of the magnitude and time of desaturation.The primary outcome was the association between intra-operative muscular tissue desaturation and POP within seven post-operative days using multivariable logistic regression.The secondary outcome was the correlation between SmtO_(2)in the forearm and that in the thigh.Results:We enrolled 174 patients.The overall incidence of muscular desaturation(defined as SmtO_(2)80%in the forearm at baseline)was approximately 47.1%(82/174).The patients with muscular desaturation had a higher incidence of pneumonia than those without desaturation(28.0%[23/82]vs.12.0%[11/92];P=0.008).The multivariable analysis revealed that muscular desaturation was associated with an increased risk of pneumonia(odds ratio:2.995,95%confidence interval:1.080-8.310,P=0.035)after adjusting for age,American Society of Anesthesiologists status,Assess Respiratory Risk in Surgical Patients in Catalonia score,smoking,use of peripheral nerve block,propofol,and study center.Conclusion:Muscular tissue desaturation,defined as a baseline SmtO_(2)80%in the forearm,may be associated with an increased risk of POP.Trial registration:No.ChiCTR-ROC-17012627.