通过脉冲波过渡时间和动脉压力波测量脉冲体积变化的比较评估
Ryoichi Ochiai1, Takashi Terada2, Noriaki Sakamoto3
1Faculty of Medicine, Toho University, Oota, Japan.
概括
冲击体积变化 (SVV) 用于预测流体响应. esCCO衍生的SVV (esSVV) 显示出比FloTrac/Vigileo衍生的SVV (flSVV) 更好的预测能力,这表明需要个性化.
科学领域:
- 关键护理医学 关键护理医学
- 麻醉学 麻醉学
- 血液动力学监测 血液动力学监测
背景情况:
- 有可用的节拍对节拍冲击体积 (SV) 监控器.
- 在正压通风期间的冲击体积变化 (SVV) 预测了流体的响应性.
研究的目的:
- 通过比较esCCO衍生的SVV (esSVV) 和FloTrac/Vigileo衍生的SVV (flSVV) 来预测流体反应.
- 评估esSVV和flSVV的诊断准确性.
主要方法:
- 测量ESVV,FSVV和中风体积指数 (SVI) 在37名接受腹腔切除术的成年患者中.
- 利用接收器运行特征 (ROC) 分析来评估预测性能.
- 确定esSVV和flSVV的最佳切割值,以预测流体响应.
主要成果:
- 与flSVV相比,esSVV在ROC曲线 (AUC) 下的面积显著更高 (p=0.030).
- 最佳切割值为esSVV的6.1%和flSVV的10%,可以预测SVI的增加>10%.
- esSVV的尤登指数较高,表明其预测准确度更高.
结论:
- 由于AUC和截止值的显著差异,esSVV和flSVV在预测流体响应方面无法直接比较.
- 个性化SVV值可能是必要的,以准确预测在个别患者的液体反应.
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