通过动脉流速时间积分来预测流体响应性的被动腿部提升测试
Issac Cheong1,2, Victoria Otero Castro3, Fernando Ariel Sosa4,5
1Department of Critical Care Medicine, Sanatorio de Los Arcos, Juan B. Justo 909, CABA, Buenos Aires, Argentina. issac_cheong@hotmail.com.
Journal of ultrasound
|September 5, 2023
概括
在被动腿抬高测试期间,动脉流速的变化可以预测重症患者的液体反应. 在被动抬腿过程中,动脉流速-时间积分的11%增加可能表明流体反应.
科学领域:
- 关键护理医学 关键护理医学
- 血液动力学 血液动力学
- 诊断的准确性 诊断的准确性
背景情况:
- 被动腿抬高试验 (PLR) 是一种评估流体反应的非侵入性方法.
- 预测液体反应对于优化重症患者血液动力学管理至关重要.
研究的目的:
- 评估通过回声多普勒评估的动脉流 (CF) 变化是否可以预测PLR机动后的液体反应.
- 为了确定CF速度-时间积分 (VTI) 在PLR期间变化的诊断准确度,以预测流体响应.
主要方法:
- 在两个重症监护病房进行了一项性能诊断研究.
- 包括具有需要液体复苏的组织低 perfusion 的迹象的患者.
- 液体反应被定义为左心室外流通道VTI在液体玻尿酸注射后增加>15%. 在PLR期间的动脉流VTI与此相比较.
主要成果:
- 在PLR期间CF VTI变化ROC曲线下的面积为0.869.
- 在PLR期间CF VTI的11%增加预测了流体反应率,具有77.3%的灵敏度和78.6%的特异性.
- 积极和消极的预测值分别为73.9%和81.5%.
结论:
- 在被动抬腿后,大于11%的动脉流量VTI的增加可能是流体响应的有用预测指标.
- 这种非侵入性方法可以帮助指导重症患者的流体治疗.
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