• Takayuki Nakajima, Kohei Kawazoe, Hiroshi Izumoto, Tsuyoshi Kataoka, Hiroyuki Niinuma, and Nobuo Shirahashi.
• Department of Cardiovascular Surgery, Iwate Medical University Memorial Heart Center, Iwate Medical University, 1-2-1 Chuodori, Morioka 020-8505, Japan.
• Surg. Today. 2006 Jan 1; 36 (8): 680-5.

PurposePostoperative hypoxemia is a frequent complication of surgery for acute type A aortic dissection. We tried to determine the factors associated with postoperative hypoxemia.MethodsBetween 1997 and 2003, 114 patients underwent surgery for acute type A aortic dissection. Multivariate logistic regression analysis was done to identify the independent predictors of postoperative hypoxemia, defined by an arterial partial oxygen/inspired oxygen fraction (PaO(2)/FiO(2)) ratio of 200 or lower.ResultsThe overall in-hospital mortality was 6.1% (7 of 114 patients), being 5.2% in the hypoxemia group and 6.9% in the non-hypoxemia group. The ventilation time and intensive care unit stay were significantly longer in the hypoxemia group than in the non-hypoxemia group (P = 0.0044, P = 0.038, respectively). Logistic regression identified the following variables as predictors for postoperative hypoxemia: body mass index > or = 25 (odds ratio [OR], 5.6; 95% confidence interval [CI], 2.1-15.01; P < 0.001), preoperative PaO(2)/FiO(2) ratio < or = 300 (OR, 2.6; 95% CI, 1.09-6.13; P = 0.031), and the volume of transfused blood (OR, 1.08; 95% CI, 1.01-1.18; P = 0.037).ConclusionsInitiating early treatment for hypoxemia and reducing the volume of blood transfused intraoperatively may improve the postoperative clinical course of obese patients with preoperative hypoxemia.

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