在各种临床场景中使用中央静脉压的变化估计腹腔压力的变化:猪模型研究
Miyako Kyogoku1, Soichi Mizuguchi2, Taku Miyasho3
1Department of Intensive Care, Osaka Women's and Children's Hospital, 840 Murodo-Cho, Izumi, Osaka, 594-1101, Japan.
Intensive care medicine experimental
|January 15, 2024
概括
使用中央静脉压力 (CVP) 估计胸腔压力 (Ppl) 是准确的,可与食道压力 (Pes) 测量相比较. 这种方法在不同的血管内体积和胸壁合规条件下仍然可靠.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统生理学 呼吸系统生理学
- 医疗器械 医疗器械 医疗器械
背景情况:
- 之前报道的一种使用中央静脉压力 (CVP) 估计胸腔压力 (Ppl) 的方法需要进一步验证.
- 在患有血管内体积变化或胸壁符合性的患者中,CVP方法的适用性尚未得到充分证实.
研究的目的:
- 调查基于CVP的方法的准确性,以估计Ppl在不同的条件下,静脉内体积和胸壁遵守.
- 为了比较CVP方法的准确性与食道压力 (Pes) 测量.
主要方法:
- 使用十只麻醉后,机械通风的猪,诱导肺损伤.
- 该研究操纵了血管内体积和腹内压力.
- 胸腔压力 (ΔPpl) 的变化直接测量,并与从CVP (cΔCVP衍生的ΔPpl) 和Pes (ΔPes) 中得出的估计值进行比较.
主要成果:
- 无论是ΔPes还是cΔCVP衍生的ΔPpl都与直接测量的ΔPpl有很强的相关性 (分别为r=0.95和r=0.97).
- 使用CVP方法的偏差 (-0.3cmH2O) 和精度 (1.9cmH2O) 与Pes测量的偏差 (偏差:0.5cmH2O,精度:1.7cmH2O) 相似.
- 血管内体积或腹内压力的变化没有显著影响精度.
结论:
- CVP方法提供了Ppl的合理准确估计,性能类似于Pes测量.
- 血管内输液体积或胸壁合规度的变化不会影响CVP方法的准确性.
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