危急病患者的流体反应使用心动脉峰值缩速度变化:一个新的前沿
Abhinob Roy1, Anant Vikram Pachisia2, Deepak Govil3
1Critical Care Medicine, Paras Hospital, Gurugram, IND.
Cureus
|August 21, 2023
概括
在流体响应者中,状动脉峰值缩速度 (CPSV) 变化在流体管理后显著下降,反映左心室外流通道 (LVOT) 速度时间积分 (VTI) 变化的变化. 这表明CPSV变异是评估流体响应性的潜在替代品.
科学领域:
- 关键护理医学 关键护理医学
- 心血管生理学心血管生理学
- 血液动力学监测 血液动力学监测
背景情况:
- 液体反应能力评估在重症监护中至关重要.
- 左心室外流管 (LVOT) 速度时间积分 (VTI) 的变化是流体响应的常见但通常难以获得的参数.
- Carotid Peak Systolic Velocity (CPSV) 变异被探索为一个可能更容易获得的代孕标记.
研究的目的:
- 评估CPSV变异作为流体响应的替代标记物的实用性.
- 评估已被确定为流体响应患者中CPSV变异的变化.
主要方法:
- 研究了接受液体玻尿酸治疗的成年患者.
- 测量LVOT VTI和CPSV变异是在6毫升/公斤液体玻尿酸注射之前和之后.
- 记录了血液动力学变量和呼吸模式 (自发与机械通风).
主要成果:
- 在自发呼吸 (14.1 ± 3.4 至 5.4 ± 2.6,p < 0.05) 和机械通风患者 (15 ± 5.3 至 6.5 ± 3.1,p < 0.005) 中,CPSV变异在液体给药后显著下降.
- 在流体治疗前,LVOT VTI变异和CPSV变异之间发现了显著的正相关性 (r=0.56,p=0.001) 和在 (r=0.37,p=0.043) 后的中度正相关性.
结论:
- 在流体响应者中,液体给药后,CPSV变异显著下降.
- CPSV变异显示出作为评估流体反应的非侵入性,易于获得的替代标记物的潜力,补充LVOT VTI.
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