title: Predicting the occurrence of oxygenation impairment in patients with type-B acute aortic dissection.
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 Po2/Fio2 ≤ 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/m(2)), a relatively high maximum body temperature on the admission day (≥ 36.5°C), DeBakey IIIb type, patent false lumen, and lower Po2/Fio2 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 Po2/Fio2 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.
authors.affiliation: Intensive Care Unit, Chiba Hokusoh Hospital, Nippon Medical School, Chiba, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Tomita
authors.affiliation: Intensive Care Unit, Chiba Hokusoh Hospital, Nippon Medical School, Chiba, Japan.
authors.forename: Noritake
authors.initials: N
authors.lastname: Hata
authors.affiliation: Intensive Care Unit, Chiba Hokusoh Hospital, Nippon Medical School, Chiba, Japan.
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Kobayashi
authors.affiliation: Intensive Care Unit, Chiba Hokusoh Hospital, Nippon Medical School, Chiba, Japan.
authors.forename: Takuro
authors.initials: T
authors.lastname: Shinada
authors.affiliation: Intensive Care Unit, Chiba Hokusoh Hospital, Nippon Medical School, Chiba, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Shirakabe
keywords: acute aortic dissection; inflammation; oxygenation impairment; prediction