关键词: 体外循环；心血管手术；重度低氧血症；危险因素 

Abstract: Objective  To investigate the risk factors of severe hypoxemia after cardiovascular surgery with cardiopulmonary bypass in adults.Methods  Retrospective analysis of clinical data of 395 adult patients after cardiovascular surgery with cardiopulmonary bypass from January 2021 to December 2021.The general socio-demographic data,disease-related data,preoperative test results,intraoperative data,test indexes within 6 hours after surgery and oxygenation index within 72 hours after surgery were collected using an electronic case system;patients with postoperative oxygenation index≤100 mmHg was defined as severe hypoxemia group(20 cases),oxygenation index＞100mmHg was defined as non-hypoxemia group (375 cases),compared the perioperative clinical data of two groups,and explored the risk factors for severe hypoxemia by multifactorial logistic review.Results A total of 395 patients were included,and the incidence of postoperative severe hypoxemia was 5.06% (20/395).Multifactorial logistic retrospective analysis showed that body mass index(OR=3.713,95%CI 1.946~ 7.083,P<0.001),preoperative neutrophil count(OR=1.164,95%CI 1.034~1.312,P<0.012),and aortic clamping time(OR=1.009,95%CI 1.001~ 1.018,P=0.030)were independent risk factors for postoperative severe hypoxemia.In addition,the duration of invasive ventilation,ICU stay,and total hospital days were prolonged and the incidence of reintubation was higher in the severe hypoxemia group(P<0.05).Conclusion  The results howed that body mass index,preoperative neutrophils count,and aortic clamping time were independent risk factors for postoperative severe hypoxemia after cardiovascular surgery with cardiopulmonary bypass,and patients with severe hypoxemia had a worse prognosis.

Key words: cardiopulmonary bypass, cardiovascular surgery；hypoxemia；risk factor