ABSTRACT
Objective:To identify the risk factors for postoperative septic cardiomyopathy (SCM) in septic patients.Methods:The perioperative medical records of septic patients admitted to the intensive care unit (ICU) of Second Affiliated Hospital of Soochow University, First Affiliated Hospital of Soochow University and Suzhou Municipal Hospital after surgery from January 2017 to November 2020 were retrospectively collected.The patients were divided into SCM group and non-SCM group (NSCM group) according to whether or not SCM developed within 48 h after operation.Multivariate logistic regression analysis was used to identify the risk factors for SCM.Results:A total of 269 patients were included in this study, including 49 patients in SCM group and 220 patients in NSCM groups.Compared with group NSCM, the rate of laparoscopic surgery, the Sequential Organ Failure Assessment (SOFA) at the time of entering ICU, the serum concentration of lactate at the time of entering ICU, the highest serum concentration of lactate, the highest serum concentration of procalcitonin, the maximum consumption of norepinephrine and the highest body temperature were increased, and the minimum platelet count was decreased in group SCM ( P<0.1). The results of logistic regression analysis showed that SOFA score at the time of entering ICU and laparoscopic surgery were the risk factors for the development of postoperative SCM in septic patients ( P<0.05). The risk for SCM was increased by 34.273 times when the SOFA score at the time of entering ICU was ≥7 ( P<0.05). Conclusion:Laparoscopic surgery and SOFA score ≥7 at the time of entering ICU are the risk factors for the development of postoperative SCM in septic patients.
ABSTRACT
Objective To investigate the effects of hydrogen-rich saline on postoperative cognitive dysfunction (POCD) in aged mice and the possible mechanism.Methods Seventy-two male C57BL/6 mice,aged 18 months,weighing 45-55 g,were randomly divided into 4 groups (n =18 each):control group (group C),hydrogen-rich saline group (group H),POCD group and POCD + hydrogen-rich saline group (group PH).POCD was induced by open tibial fracture.Hydrogen-rich saline 10 ml/kg was injected intraperitoneally twice a day for 7 days before surgery.Six mice were chosen at day 1,3 and 7 after surgery and cognitive function was assessed by Morris water maze test.The mice were then sacrificed and hippocampus was isolated for determination of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) contents (by ELISA) and nuclear factor-κB (NF-κB) activity.Results Compared with group C,the escape latency was significantly prolonged,the time of staying at the original platform quadrant was shortened,the frequency of crossing the original platform was decreased at 3 and 7 days after surgery,and the contents of NF-α and IL-1β and NF-κB activity were increased during 1,3 and 7 days after surgery in group POCD (P ＜ 0.05),and no significant change was found in the parameters mentioned above in group H (P ＞ 0.05).Compared with group POCD,the escape latency was significantly shortened,the time of staying at the original platform quadrant was prolonged,the frequency of crossing the original platform was increased at 3 and 7 days after surgery,and the contents of NF-α and IL-1β and NF-κB activity were decreased at 1,3 and 7 days after surgery.Conclusion Hydrogen-rich saline can alleviate POCD via inhibiting NK-κB activity in hippocampus and reducing inflammatory response.