title: [Risk factors and prognosis of hypotension in postoperative sedation patients].
abstract: OBJECTIVE
  To explore the risk factors and prognosis of hypotension in postoperative sedation patients.
  
  
  METHODS
  A total of 175 patients with postoperative sedation at our department from May 2013 to March 2014 were retrospectively reviewed. Patients with age <18 years, cardiac surgery, pheochromocytoma surgery, hemorrhagic shock, septic shock or cardiogenic shock were excluded. APACHE II, dosage and duration of sedative drug, mean arterial pressure at baseline and after sedation, central venous pressure, fluid balance, dosage and duration of norepinephrine, endotracheal intubation time and length of intensive care unit (ICU) stay were recorded.
  
  
  RESULTS
  Blood pressures decreased significantly after administration of sedation (77.2 ± 11.2 vs 82.6 ± 9.3 mmHg, P = 0.000). Compared to those with lower disease severity (APACHEII ≤ 10), the patients with APACHEII.>10 required higher norepinephrine dosage and longer time of infusion. A longer time of norepinephrine infusion was needed for patients with coronary heart disease. Patients undergoing thoracic, abdominal or pelvic surgery, or those with hepatic dysfunction had a higher norepinephrine dosage. Decrement of blood pressure and norepinephrine duration were independent risk factors of endotracheal intubation time. And dosage and duration of norepinephrine were independent risk factors of ICU time.
  
  
  CONCLUSIONS
  Disease severity, past history of heart disease, surgical site and liver function are risk factors of hypotension in postoperative sedation patients. It is important to pay attention to dosage and administrative route of sedative drug. Norepinephrine duration after sedation is an independent risk factor of endotracheal intubation time and ICU time.
authors.affiliation: Department of Critical Care Medicine, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Tang
authors.affiliation: Department of Critical Care Medicine, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Xiaoting
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Critical Care Medicine, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing 100730, China. Email: dwliu@medmail.com.cn.
authors.forename: Dawei
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Critical Care Medicine, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Hongmin
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Critical Care Medicine, Peking Union Medical College Hospital & Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Huaiwu
authors.initials: H
authors.lastname: He
mesh_terms: D018806:APACHE; D001794:Blood Pressure; D006348:Cardiac Surgical Procedures; D006331:Heart Diseases; D006801:Humans; D007022:Hypotension; D007362:Intensive Care Units; D009638:Norepinephrine; D011184:Postoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012772:Shock, Septic; D014882:Water-Electrolyte Balance
chemical_list: D009638:Norepinephrine