脑卒中体积变化和动态动脉弹性预测流体反应,即使在胸腔镜食道切除术:一个前性观察性研究
Yukiko Hikasa1, Satoshi Suzuki2, Shunsuke Tanabe3
1Department of Anesthesia and Intensive Care, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. yhikasa@ncc.go.jp.
Journal of anesthesia
|September 21, 2023
概括
冲击体积变化 (SVV) 和动态动脉弹性 (Eadyn) 可靠地预测胸腔镜食道切除术期间的液体反应. 脉冲压变化 (PPV) 在这个患者群体中不是一个合适的指标.
科学领域:
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 胸部外科手术 胸部外科手术
背景情况:
- 液体管理在重大手术中至关重要,如胸腔镜食道切除术 (TE).
- 在TE中,随着单肺通风的倾斜姿势对血液动力学监测提出了独特的挑战.
- 在这种特定情况下,动态参数对于流体响应的实用性仍然不清楚.
研究的目的:
- 为了评估中风体积变化 (SVV),脉冲压变化 (PPV) 和动态动脉弹性 (Eadyn) 在预测流体响应性的准确性.
- 为了确定这些动态指数的可靠性,在倾斜位置的胸腔镜食道切除术 (TE) 中.
主要方法:
- 监测了24名接受TE治疗的患者.
- 液体响应被评估为15%的增加中风体积指数在200毫升的液体玻尿酸后.
- 接收机运行特征 (ROC) 曲线被用来计算SVV,PPV和Eadyn的曲线下的面积 (AUROC).
主要成果:
- SVV和Eadyn显示了流体响应者和不响应者之间的显著差异 (P <0.001).
- AUROC为SVV的0.76和Eadyn的0.82,表明了良好的预测准确性.
- PPV没有显示显著差异或预测值 (AUROC = 0.56).
结论:
- SVV和Eadyn是指导TE患者流体管理的可靠指标.
- 这些动态参数可以帮助在这个复杂的手术过程中优化流体治疗.
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