Application of hyperbaric oxygen combined with alprostadil in the treatment of congenital heart disease with severe pulmonary hypertension in perioperative period
Objective To observe the effect of hyperbaric oxygen(HBO)combined with alprostadil in the treatment of congenital heart disease(CHD)with severe pulmonary hypertension(PH)during the perioperative period.Methods A total of 118 patients with CHD combined with severe PH admitted to Department of Cardiovascular Surgery of Linyi Central Hospital from January 2021 to January 2023 were selected.They were divided into single treatment group(58 cases)and combined treatment group(60 cases)by double-blind and lottery method.Patients in both groups received conventional surgical treatment;the single treatment group received alprostadil from seven days before surgery to seven days after surgery,and the combined treatment group received alprostadil according to the regimen of the single treatment group and HBO therapy 15 days before surgery.The hemodynamic indexes of the two groups were compared at admission(T0),seven days after preoperative treatment with alprostadil(T1),and seven days after surgery(T2):mean pulmonary artery pressure(MPAP),mean systemic arterial pressure(MSAP),systemic vascular resistance(SVR),pulmonary vascular resistance(PVR),pulmonary arterial pressure/aortic pressure(Pp/Ps),and arterial oxygen saturation(SaO2).Aortic occlusion time,cardiopulmonary bypass time,ventilator time,and ICU stay were compared between the two groups.Results There was no significant difference in hemodynamic indexes at T0 between the two groups(P＞0.05).The indicators of MPAP,MSAP,SVR,PVR,and Pp/Ps of the combined treatment group were lower than those of the single treatment group at T1 and T2,but SaO2 of the combination treatment group was higher than that of the single treatment group,with statistically significant differences(P＜0.05).There was no significant difference in cardiopulmonary bypass time and aortic occlusion time between two groups(P＞0.05).The duration of ventilator intubation and ICU stay in the combined treatment group were shorter than those in the single treatment group,and the differences were statistically significant(P＜0.05).Conclusion Compared with using alprostadil alone,HBO combined with alprostadil in CHD patients with severe PH during perioperative period can significantly reduce MPAP and increase SaO2,thus effectively shortening the time of ventilator use and ICU stay.
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