上腺素对麻醉引起的低血压的微和宏循环效应:一项前性初步研究
Manuel Kindermans1, Jona Joachim2,3, Elsa Manquat2,3
1Department of Anaesthesiology and Intensive Care, Lariboisière - Saint Louis Hospitals, 02 rue Ambroise Paré, 75010, Paris, France. manuel.kindermans@aphp.fr.
持续输注诺阿皮内林可能比玻尿酸治疗手术内低血压的好处更大,在神经外科患者中改善了宏循环和微循环参数.
科学领域:
- 麻醉学 麻醉学
- 临界护理医学 临界护理医学
- 血管生理学 血管生理学
背景情况:
- 内手术性动脉低血压 (IOH) 与术后并发症增加有关.
- 上腺素是IOH的常见治疗方法,但其最佳的施用方法 (玻尿酸与连续输液) 是有争议的.
研究的目的:
- 为了比较玻尿酸对抗持续输注的效果在神经外科手术期间IOH患者的宏循环和微循环上.
主要方法:
- 涉及成年神经外科患者的前性观察性研究,具有侵入性监测.
- 使用视频毛囊镜,激光多普勒,NIRS和组织pCO2.2评估的微循环.
- 上腺素作为IOH的10微克玻尿酸或200微克/小时连续输液.
主要成果:
- 这两种方法都增加了平均动脉压,其中一个趋势是有利于大血压.
- 持续输注显示心脏输出量和中风体积的减少较小 (p<0.05).
- 微循环参数,包括微血管流量指数和输液指数,在两种方法之间有显著差异,有利于持续输液.
结论:
- 持续输注上腺素 (norepinephrine) 在治疗IOH方面可能比玻尿酸注射更有益.
- 结果表明,随着持续输液,大循环和微循环动力学得到了改善.
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