我们是否应该使用透缩功能参数来确定心脏外科手术中的预负载响应能力? 一个试点研究研究
Athanase Courbe1, Clotilde Perrault-Hébert1, Iolanda Ion1
1Department of Anesthesiology, Montreal Heart Institute, Université de Montréal, 5000 Belanger Street, Montreal, Quebec, H1T 1C8, Canada.
Journal of anesthesia, analgesia and critical care
|June 29, 2023
概括
扩张功能参数没有预测绕道移植手术患者的液体反应. 在这项试点研究中,中风体积变化 (SVV) 是流体响应的唯一独立预测因素.
科学领域:
- 心脏病学 心脏病学
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
背景情况:
- 左心室扩张功能 (LV DF) 是流体响应的潜在预测因素.
- 很少有研究研究了透缩功能在流体反应中的作用.
- 这项试点研究旨在评估LV和右心室透静功能参数,以预测液体反应.
研究的目的:
- 为了确定透析功能参数,包括 mitra E/e' 比率,预测在接受冠状动脉旁路移植 (CABG) 患者的流体响应.
- 为了比较心声回应和血液动力学参数,包括脉冲压力变化和中风体积变化 (SVV),以评估流体响应.
主要方法:
- 对57名接受CABG的患者进行前性研究.
- 在500毫升晶体注后,通过心脏指数15%的增加来评估液体反应.
- 测量包括过食管回声心电图 (TEE),辐射动脉导管和肺动脉导管 (用于心脏输出).
主要成果:
- 确定了21名受访者 (36.8%) 和36名非受访者 (63.2%) 的情况.
- 响应者和不响应者之间在基线透析功能参数 (心关,三,肺或肝静脉流量或E / e'比率) 中没有显著差异.
- 冲击体积变化 (SVV) 是液体反应能力的唯一独立预测指标 (P = 0.0208).
结论:
- 扩张功能参数与CABG患者的流体反应性无关.
- 冲击体积变化 (SVV) 成为预测该队列中流体响应性的最可靠参数.
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