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Int J Angiol 2014; 23(01): 053-060
DOI: 10.1055/s-0033-1349398
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Predicting the Occurrence of Oxygenation Impairment in Patients with Type-B Acute Aortic Dissection

Kazunori Tomita
1   Intensive Care Unit, Chiba Hokusoh Hospital, Nippon Medical School, Chiba, Japan
,
Noritake Hata
1   Intensive Care Unit, Chiba Hokusoh Hospital, Nippon Medical School, Chiba, Japan
,
Nobuaki Kobayashi
1   Intensive Care Unit, Chiba Hokusoh Hospital, Nippon Medical School, Chiba, Japan
,
Takuro Shinada
1   Intensive Care Unit, Chiba Hokusoh Hospital, Nippon Medical School, Chiba, Japan
,
Akihiro Shirakabe
1   Intensive Care Unit, Chiba Hokusoh Hospital, Nippon Medical School, Chiba, Japan
› Author Affiliations
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Publication History

Publication Date:
07 February 2014 (online)

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Abstract

Complicated respiratory failure requiring mechanical ventilation in patients with type-B acute aortic dissection (AAD) has been previously reported, and inflammatory reactions have been found to be associated with the occurrence of oxygenation impairment (OI). However, the possibility of predicting the occurrence of OI in patients with type-B AAD has not yet been evaluated. This study was performed to investigate the possibility of predicting the occurrence of OI in type-B AAD. In this study, 79 type-B AAD patients were enrolled to investigate the possibility of predicting the occurrence of OI. OI was defined as Po 2/Fio 2 ≤ 200. Patient characteristics, type of AAD, vital signs on admission, and the presence of inflammatory reactions obtained on admission day were evaluated. OI occurred in 39 patients (49%) on hospital day 2.5 ± 1.4 on average. Younger age, male gender, nonslender frame (body mass index ≥ 22 kg/m2), a relatively high maximum body temperature on the admission day (≥ 36.5°C), DeBakey IIIb type, patent false lumen, and lower Po 2/Fio 2 on admission were found to be associated with the occurrence of OI. Multivariate analysis revealed that nonslender frame, relatively high body temperature on the admission day, and lower Po 2/Fio 2 on admission were reliable for predicting the occurrence of oxygen impairment. The occurrence of OI in type-B AAD can be predicted in the clinical setting.

Keywords

acute aortic dissection - inflammation - oxygenation impairment - prediction
 

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