Zaid ABDULKAREM, Mediha TÜRKTAN, Ersel GÜLEÇ, Zehra HATİPOĞLU, Hulya BİNOKAY, Dilek ÖZCENGİZ

Entegre pulmoner indeks ile göğüs cerrahisi hasta takip verileri arasında ilişki var mı? prospektif, gözlemsel çalışma

Amaç: Bu çalışmada göğüs cerrahisi sonrası hastaların demografik verileri, cerrahi özellikleri, postoperatif komplikasyonları, kan gazı analizi ve hemodinamik değerleri ile entegre pulmoner indeks arasındaki ilişkiyi araştırdık. Gereç ve Yöntem: Bu çalışmaya elektif göğüs cerrahisi planlanan toplam 97 hasta dahil edildi. Ameliyat sonrası anestezi sonrası bakım ünitesindeki tüm hastalara entegre pulmoner indeks monitörizasyonu uygulandı. Hastaların demografik özellikleri, postoperatif hemodinamik değerleri, arteriyel kan gazı analizleri, hastanede kalış süreleri, postoperatif komplikasyonlar, anestezi süreleri ve ameliyat süreleri kaydedildi. Bu değerlerin ameliyat sonrası 30. dakika, 1. saat ve 2. saat entegre pulmoner indeks skorları ile korelasyonları araştırıldı. Bulgular: Hastaların demografik verileri ve cerrahi özelliklerinin entegre pulmoner indeks skorlarını etkilemediği görüldü. Entegre pulmoner indeks skorları ile anestezi süresi, ameliyat süresi, postoperatif komplikasyonlar veya hastanede kalış süresi arasında anlamlı bir ilişki bulunamadı. Ancak postoperatif hemodinamik değerler ile arteriyel kan gazı analizi ve entegre pulmoner indeks skoru arasında korelasyon mevcuttu). Sonuç: Entegre pulmoner indeks monitorizasyonu, tek ekranda birden fazla parametreyi göstermesi, arteriyel kan gazı analizi ve hemodinamik değerleri ile korelasyon göstermesi, yatak başı ve non-invaziv bir yöntem olması nedeniyle göğüs cerrahisi hastalarının erken takibinde avantajlar sağlayabilir. Ancak entegre pulmoner indeksin göğüs cerrahisi geçiren hastalardaki etkinliğini araştırmak için daha fazla sayıda hastayı içeren, çok merkezli, randomize kontrollü çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

Kan gazı analizi, hemodinamik değerler, entegre pulmoner indeks, monitörizasyon, postoperatif komplikasyonlar, göğüs cerrahisi

Is there any correlation between integrated pulmonary index and thoracic surgery patients’ follow-up data? a prospective, observational study

Purpose: In this study, we investigated the relationship between integrated pulmonary index and patients’ demographic data, surgical characteristics, postoperative complications, blood gas analysis, and hemodynamic values after thoracic surgery. Materials and Methods: A total of 97 patients scheduled for elective thoracic surgery were included in this study. After surgery, integrated pulmonary index monitoring was performed for all patients in the post-anesthetic care unit. Patients’ characteristics, postoperative hemodynamic values, arterial blood gas analysis, length of hospital stay, postoperative complications, duration of anesthesia, and duration of surgery were recorded. Their correlations with postoperative integrated pulmonary index scores at 30 minutes, 1 hour, and 2 hours were investigated. Results: Patients’ demographic data and surgical characteristics did not affect integrated pulmonary index scores. No significant correlation was found between integrated pulmonary index scores and duration of anesthesia, duration of surgery, postoperative complications, or length of hospital stay. However, there was a correlation between postoperative hemodynamic values, arterial blood gas analysis and integrated pulmonary index score. Conclusion: Integrated pulmonary index monitoring is a bedside and non-invasive method that displays multiple parameters on a single screen, corraletes with arterial blood gas analysis and hemodynamic values. Therefore, it may provide advantages in early follow-up of thoracic surgery patients. However, multicenter, randomized controlled studies with a larger number of patients are needed to investigate the efficacy of integrated pulmonary index in patients undergoing thoracic surgery.

Keywords:

blood gas analysis, hemodynamic values, integrated pulmonary index, monitoring, postoperative complications, thoracic surgery,

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Fot EV, Izotova NN, Yudina AS, Smetkin AA, Kuzkov VV, Kirov MY. The predictive value of integrated pulmonary index after off-pump coronary artery bypass grafting: A prospective observational study. Front Med. 2017;4:132.
Ronen M, Weissbrod R, Overdyk FJ, Ajizian S. Smart respiratory monitoring: clinical development and validation of the IPI™ (Integrated Pulmonary Index) algorithm. J Clin Monit Comput. 2017;31:435-42.
Agostini P, Cieslik H, Rathinam S, Bishay E, Kalkat MS, Rajesh PB, et al. Postoperative pulmonary complications following thoracic surgery: are there any modifiable risk factors? Thorax. 2010;65:815-8.
McKenna RJ, Jr., Houck W, Fuller CB. Video-assisted thoracic surgery lobectomy: experience with 1,100 cases. Ann Thorac Surg. 2006;81:421-5; discussion 425-6.
Cheng D, Downey RJ, Kernstine K, Stanbridge R, Shennib H, Wolf R, et al. Video-assisted thoracic surgery in lung cancer resection: a meta-analysis and systematic review of controlled trials. Innovations (Phila). 2007;2:261-92.
Kawachi R, Tsukada H, Nakazato Y, Takei H, Koshi-ishi Y, Goya T. Morbidity in video-assisted thoracoscopic lobectomy for clinical stage I non-small cell lung cancer: is VATS lobectomy really safe? Thorac Cardiovasc Surg. 2009;57:156-9.
Epstein SK, Ciubotaru RL, Wong JB. Effect of failed extubation on the outcome of mechanical ventilation. Chest. 1997;112:186-92.
Kaur R, Vines DL, Liu L, Balk RA. Role of integrated pulmonary index in identifying extubation failure. Respir Care. 2017;62:1550-6.
Kaur R, Vines DL, Patel AD, Lugo-Robles R, Balk RA. Early identification of extubation failure using integrated pulmonary index and high-risk factors. Respir Care. 2021;66:1542-8.
Kuroe Y, Mihara Y, Okahara S, Ishii K, Kanazawa T, Morimatsu H. Integrated pulmonary index can predict respiratory compromise in high-risk patients in the post-anesthesia care unit: a prospective, observational study. BMC Anesthesiol. 2021;21:123.
Garah J, Adiv OE, Rosen I, Shaoul R. The value of Integrated Pulmonary Index (IPI) monitoring during endoscopies in children. J Clin Monit Comput. 2015;29:773-8.
Yildirim Ar A, Abitagaoglu S, Turan G, Karip CS, Akgun N, Boybeyi DM, et al. Integrated Pulmonary Index (IPI) monitorization under sedation in cataract surgery with phacoemulsification technique. Int Ophthalmol. 2019;39:1949-54.
Overdyk FJ, Carter R, Maddox RR, Callura J, Herrin AE, Henriquez C. Continuous oximetry/capnometry monitoring reveals frequent desaturation and bradypnea during patient-controlled analgesia. Anesth Analg. 2007;105:412-8.
Akcil EF, Korkmaz Dilmen O, Ertem Vehid H, Yentur E, Tunali Y. The role of "Integrated Pulmonary Index" monitoring during morphine-based intravenous patient-controlled analgesia administration following supratentorial craniotomies: a prospective, randomized, double-blind controlled study. Curr Med Res Opin. 2018;34:2009-14.
Turan G KY, Karip C, Koksal C, Akın C, Akgun N. Integrated Pulmonary Index: a new strategy for respiratory patients evaluation. Int J Anesthetic Anesthesiol. 2016;3:402.
Berkenstadt H, Ben-Menachem E, Herman A, Dach R. An evaluation of the Integrated Pulmonary Index (IPI) for the detection of respiratory events in sedated patients undergoing colonoscopy. J Clin Monit Comput. 2012;26:177-81