Risk factors for postoperative hypoxemia after whole lung lavage in patients with pneumoconiosis and the predictive value of ultrasound indicators
10.20001/j.issn.2095-2619.20251014
- VernacularTitle:尘肺病患者大容量全肺灌洗术后并发低氧血症因素与超声预测价值分析
- Author:
Lingwei LI
1
;
Lin CHEN
;
Qinghua ZHONG
;
Yucheng DENG
;
Qi LIU
Author Information
1. Department of Anesthesiology, Ganzhou Fifth People's Hospital, Ganzhou, Jiangxi 341000, China
- Publication Type:Journal Article
- Keywords:
Pneumoconiosis;
Large-volume whole lung lavage;
Hypoxemia;
Influencing factors;
Ultrasound indicators;
Predictive value;
Receiver operating characteristic curve
- From:
China Occupational Medicine
2025;52(5):564-569
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the influencing factors of postoperative hypoxemia after whole lung lavage (WLL) in patients with pneumoconiosis and to evaluate the predictive value of lung ultrasound scores. Methods A total of 757 patients with pneumoconiosis who underwent unilateral large-volume WLL were selected as the research subjects by continuous sampling method. The patients with hypoxemia after large-volume WLL were assigned to the observation group (82 cases), and those without hypoxemia were assigned to the control group (675 cases). Patients′ basic information and clinical data of the two groups were collected using a retrospective investigation method. The binary logistic regression analysis was used to analyze the influencing factors of hypoxemia after large-volume WLL in patients with pneumoconiosis, and receiver operating characteristic (ROC) curve analysis was conducted to assess the predictive value of ultrasound indicators. Results The combined rate of postoperative hypoxemia in the patients was 10.8% (82/757). The multivariate logistic regression analysis showed that the risk of hypoxemia in patients aged ≥65 years was higher than that in patients aged <65 years (P<0.05). The risk of hypoxemia was higher in patients with increased pre-extubation lung ultrasound score than those with lower pre-extubation lung ultrasound score (P<0.01). Patients with a higher partial pressure of carbon dioxide in arterial blood (PaCO2) had a higher risk of concurrent hypoxemia than those with a lower pressure (P<0.01), while patients with lower arterial partial pressure of oxygen (PaO2) had a higher risk of concurrent hypoxemia than those with higher PaO2 (P<0.01). Pearson correlation analysis showed that lung ultrasound scores were negatively correlated with PaO2 and positively correlated with PaCO2 (both P<0.01). The ROC curve analysis showed that the area under the curve was 0.855, the 95% confidence interval was 0.828 to 0.879, the diagnostic sensitivity was 84.2%, and the specificity was 75.1%. Conclusion Age, pre-extubation lung ultrasound score, and PaCO₂ are risk factors for hypoxemia after WLL in patients with pneumoconiosis, while PaO₂ is a protective factor. Pre-extubation lung ultrasound scoring demonstrates good accuracy in predicting postoperative hypoxemia among pneumoconiosis patients after WLL.
