在接受剖腹产分娩的患者中使用补偿储备指数检测产后出血
Marina L Reppucci1,2, Jonathan Seth Rogerson3, Kaci Pickett4
1From the Division of Pediatric Surgery, Children's Hospital Colorado, Aurora, Colorado.
Anesthesia and analgesia
|August 8, 2023
概括
补偿储备指数 (CRI) 有效地识别了剖腹产分娩期间产后出血 (PPH) 风险. 较低的CRI值表明PPH可能性更高,为孕产妇的护理提供了至关重要的早期预警.
科学领域:
- 产科和妇科 产科和妇科
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
背景情况:
- 产后出血 (PPH) 是全球产妇死亡的主要原因.
- 早期发现和管理PPH对于改善患者的治疗结果至关重要.
- 补偿储备指数 (CRI) 是跟踪血管内体积变化的新参数.
研究的目的:
- 为了调查CRI模式是否在患有PPH的患者和在剖腹产期间没有PPH的患者之间有所不同.
- 将CRI趋势与美国麻醉学会 (ASA) 非侵入性监测标准进行比较.
主要方法:
- 51名经历剖腹产的分娩妇女在手术期间和分娩后被监测CRI值.
- 患者被分为PPH (血液损失>1000毫升) 和非PPH组.
- 函数对标尺回归分析了各组之间的CRI趋势,但不包括全身麻醉和子宫前患者的亚分析.
主要成果:
- 与非PPH组相比,患有PPH的患者在分娩后的CRI值显着较低 (P < .001).
- 平均动脉压 (MAP) 没有显示群体之间的统计学上显著差异 (P = .09).
- 观察到的CRI趋势在亚分析中持续存在,包括那些不包括全身麻醉和先兆子患者的亚分析.
结论:
- CRI有效地检测到中央体积状态的变化,在识别PPH相关的体积转移方面表现优于MAP.
- CRI显示出作为持续监测工具的潜力,以提醒提供者在剖腹产中PPH期间急性中央体积变化.
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