动态动脉弹性作为斜背至斜背低血压的预测因素 (SuProne研究):一项观察性研究
Jin Hee Ahn1, Jiyeon Park1, Jae-Geum Shim1
1Department of Anesthesiology and Pain Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea.
Medicina (Kaunas, Lithuania)
|December 23, 2023
概括
动态动脉弹性 (Eadyn) 在脊柱手术期间不能预测卧卧式低血压. 相反,高卧式静脉压和dP/dt预测患者倾斜时的低血压.
科学领域:
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 心血管生理学心血管生理学
背景情况:
- 在脊柱手术期间,背部至部低血压是一个显著的风险,通常与增加的胸内压力和减少静脉回流有关.
- 动态动脉弹性 (Eadyn) 是一种流体反应的指标和潜在的低血压预测器.
研究的目的:
- 评估动态动脉弹性 (Eadyn) 对于在接受选择性脊柱手术的患者的卧底至卧底低血压的预测能力.
- 确定其他可能预测这种类型低血压的血液动力学参数.
主要方法:
- 一项前性观察性研究,涉及47名接受选择性脊柱手术的患者.
- 收集的血液动力学数据包括平均动脉压 (MAP),缩动脉压 (SAP),中风体积变化 (SVV),脉冲压变化 (PPV) 和低血压预测指数 (HPI) 在仰卧和倾斜的位置.
- 被定义为卧底至倾斜的低血压,即MAP>20%的下降,或特定的倾斜MAP/SAP值.
主要成果:
- 在27.7%的患者中,发生了从体到体的低血压.
- Eadyn没有显著预测卧底至卧底低血压 (AUC,0.569).
- 更高的卧底静脉压 (>139 mmHg) 和卧底dP/dt (>981 mmHg/s) 是低血压的显著预测因素 (AUC分别为0.760和0.765).
结论:
- 动态动脉弹性不是在这个手术群体中靠至俯卧式低血压的可靠预测指标.
- 术前的缩动脉压和卧姿的dP/dt是预测卧姿下低血压的有价值指标.
- 卧卧式低血压参数与低血压有关,当患者重新放置倾斜时.
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