An Unconditional Logistic Regression Analysis Of Factors Of The Incidence Of Hypoxemia In One-Lung Ventilation

Objective:Hypoxemia is a serious complication in one-lung ventilation during thoracoscopic surgery,There are many studies on hypoxemia in one-lung ventilation,while most studies are based on univariate analysis.Compare with univariate analysis,multiple variable analysis ensures a more reliable conclusion taking into account interaction and interconnections between individual factors.This study collected the medical records of the First Affiliated Hospital of Dalian Medical University and Multivariate logistic regression analysis was used to analyze the factors influencing the occurrence of hypoxemia in one-lung ventilation during thoracoscopic surgery.The aim of this study is to explore the risk factors for hypoxemia in one-lung ventilation during thoracoscopic surgery,and to provide a reference for the prediction of hypoxemia and the prevention and treatment of hypoxemia in one-lung ventilation during thoracoscopic surgery.Methods:In this study,551 cases of patients with thoracoscopic surgery were examined by retrospective analysis of the collected First Affiliated Hospital of Dalian Medical University from August 2016 to December 2016.Medical records include general information on the collection of patients(Sex,age),past history(whether the regular use of vasoactive drugs,lung disease history),preoperative conditions(erythrocyte levels,albumin levels,lung function,renal function,ASA,echocardiography),intraoperative conditions(surgical type,surgical position,double-lumen bronchial catheter type,anesthesia,MAP,start one-lung ventilation time from the start of surgery).Unicariate analysis for these factors were performed at the test level 0.05.Stepwise logistic regression were performed for factors with significance(p<0.05)to obtain independent risk factors.To explore the risk factors for hypoxemia in one-lung ventilation during thoracoscopic surgery,and to provide a reference for the prediction of hypoxemia and the prevention and treatment of hypoxemia in one-lung ventilation during thoracoscopic surgery.Result:In this total of 551 cases were included in the occurrence of hypoxemia in 49 cases,the incidence was 8.9%.In univariate analysis,six factors were associated with the occurrence of hypoxemia in one-lung ventilation during thoracoscopic surgery.They are as follow:ASA(P=0.002,r= 0.129),lung function(P=0.034,r=-0.090),start one-lung ventilation time from the start of surgery(P=0.071,r=-0.077),echocardiography(P=0.024,r=0.096),whether the regular use of vasoactive drugs(P=0.037,r= 0.089),surgical type(P=0.032,r= 0.091).In multivariate analysis,five factors were associated with the occurrence of hypoxemia in one-lung ventilation during thoracoscopicsurgery.Echocardiography(OR=2.405,P=0.018),ASA(OR=2.378,P=0.008),and surgical type(OR=1.389,P=0.021)are risk factors.Lung function(OR=0.502,P=0.047)and start one-lung ventilation time from the start of surgery(OR=0.594,P=0.024)are protective factors.Conclusion:1.The echocardiography,ASA and surgical type are risk factors for hypoxemia in one-lung ventilation during thoracoscopic surgery.With the increase in ASA,changes in surgical types and abnormal echocardiography,the occurrence of hypoxemia will increase in one-lung ventilation during thoracoscopic surgery.2.Lung function and start one-lung ventilation time from the start of surgery are protective factors for hypoxemia in one-lung ventilation during thoracoscopic surgery.With the abnormal lung function and increase the time the occurrence of hypoxemia will decline in one-lung ventilation during thoracoscopic surgery.