Early acute lung injury following Stanford A aortic dissection / 中国综合临床

ABSTRACT

Objective To investigate the clinical biomarkers of acute lung injury(ALI) after the Stanford A aortic dissection.Methods Thirty patients underwent Stanford A aoatic dissection were selected as subjects,who hospitalized from January 2006 to March 2013.Of which,21 patients underwent total arch replacement with stented elephant trunk procedure and 9 patients underwent triple-branched stent graft placement.The general information of patients,preoperation echocardiogram data,and arterial partial pressure of oxygen (PaO2),partial pressure of carbon dioxide (PaCO2) and fraction of inspired oxygen(FiO2) were recorded before,after the operation and entering ICU.Alveolar-arterial oxygen difference (A-aDO2),oxygenation index (OI) were calculated.Results A-aDO2 and OI at preoperation,postoperative and entering ICU point were (112.47 ±41.06) mmHg,(136.13 ± 29.51) mmHg and (141.37 ± 25.94) mmHg; (535.23 ± 70.15) mmHg; (491.50 ± 73.12) mmHg and (387.33 ± 91.32) mmHg respectively,and the differences were significant (F=35.926,323.742;P =0.000).The levels of A-aDO2 and OI at entering ICU were significant different from that of pre-operation and post-operation (P ＜ 0.01,P ＜ 0.05).Conclusion Early postoperative oxygenation and switching functions of patients with Stanford A aortic dissection are subject to damage to some degree.The A-aDO2 and OI might be sensitive biomarkers of the diagnosis for early acute lung injury of aortic dissection patients.