在接受腹部外科手术的新生儿中,以系统学变化指数为指导的目标定向液体治疗与传统的自由液体治疗相比:一项前性随机对照试验
A S Swathy1, Anudeep Jafra2, Neerja Bhardwaj2
1Department of Anaesthesia and Intensive Care, All India Institute of Medical Sciences, New Delhi, India.
Paediatric anaesthesia
|February 13, 2024
概括
使用囊学变异性指数的目标导向液体治疗与接受腹部手术的新生儿的自由液体治疗相当. 这两种方法都显示在外科手术期间注入的液体体积相似.
科学领域:
- 麻醉学 麻醉学
- 儿科手术 儿科手术
- 关键护理医学 关键护理医学
背景情况:
- 在手术期间维持生理稳定性至关重要.
- 斑管学变异性指数 (PVI) 可以预测流体反应,但其在指导手术内流体管理中的临床应用仍然不清楚.
- 接受腹部手术的新生儿需要谨慎的流体管理,以防止并发症.
研究的目的:
- 为了比较由PVI指导的目标导向流体疗法 (GDFT) 与经过腹部手术的新生儿的自由流体疗法 (LFT).
- 评估这些流体策略对手术内和术后结果的影响.
主要方法:
- 一项前性随机对照试验,涉及30名接受腹部手术的新生儿.
- 新生儿被随机分配到PVI引导的GDFT (PVI<18) 或LFT.
- 主要结局:整体手术内流体注入. 二次结局:血液气体参数,生化标志物,血管压缩剂使用,并发症和住院.
主要成果:
- 在GDFT和LFT组之间注入的整体手术内流体没有显著差异.
- 在服用多巴胺之前注入的液体量在GDFT组明显低于LFT组.
- 术后的24小时液体摄入量在两组之间是可比的.
结论:
- 术内PVI引导的GDFT与新生儿接受腹部手术时的LFT相比,在注入的液体总体量方面是可比的.
- 需要使用更大的样本大小进行进一步的研究来证实这些发现.
- 这项研究表明,PVI可能有助于优化液体施用时间,可能减少早期血管压缩剂的需求.
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