Key result
High-pressure excursion occurred in 0.31% (16 of 5,180) of cardiopulmonary bypass cases, with 69% occurring immediately after initiation, and could be classified into 6 distinct patterns based on pressure trends and timing.
Observational (n=5,180)
No
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High-pressure excursions during cardiopulmonary bypass occur in about 0.31% of cases, most frequently immediately after initiation, and can be classified into six distinct patterns to guide troubleshooting and potential oxygenator replacement.
2018年1月から2022年12月までで、当院で発生した人工肺内圧上昇（high-pressure excursion：HPE）を認めた症例について、圧力データを主に後ろ向きに検討した。HPEの発生率は0.31％（5,180症例中16症例）で、4種の人工肺が使用されていた。それぞれの発生率は人工肺Aが0.51％（588症例中3症例）、人工肺Bが1.67％（120症例中2症例）、人工肺Cが0.37％（1,348症例中5症例）、人工肺Dが1.85％（325症例中6症例）であった。人工肺抵抗値の圧力推移で、上昇後に正常値まで帰するもの、上昇したままのもの、人工心肺が継続不可となるものが存在した。発生時期は、最も多いのは人工心肺開始直後であり、HPE全体の69％であった。我々はHPEの圧力推移と発生時期で6つの形態に分類した。それぞれの形態では危険度は異なり、形態毎の対応方法を検討しておくことが重要であると考える。
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Tanabe et al. (2024) conducted an observational in Cardiopulmonary bypass during cardiac surgery (n=5,180). Cardiopulmonary bypass oxygenators was evaluated on Incidence of high-pressure excursion (HPE). High-pressure excursion occurred in 0.31% (16 of 5,180) of cardiopulmonary bypass cases, with 69% occurring immediately after initiation, and could be classified into 6 distinct patterns based on pressure trends and timing.
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