动脉血流作为脉冲轮分析的替代品,用于评估液体反应:一个前性,观察性,单中心研究 (轮研究)
Anirban Karmarkar1, Divya Pal2, Deepak Govil2
1Critical Care Medicine, Medica Superspeciality Hospital, Kolkata, IND.
Cureus
|March 4, 2024
概括
动脉多普勒 (CBF) 显示出作为一种非侵入性方法来评估流体响应性手术患者的心脏输出 (CO) 的前景. 这项研究发现CBF测量与脉冲轮分析有很好的相关性,这表明它在指导流体治疗中的实用性.
科学领域:
- 关键护理医学 关键护理医学
- 心血管生理学心血管生理学
- 医疗技术评估 医疗技术评估
背景情况:
- 在重症患者中非侵入性评估心脏输出 (CO) 仍然具有挑战性.
- 动脉多普勒 (CBF) 为血液动力学监测提供了一个有希望的,非侵入性的床边方法.
- 这项研究旨在将CBF与脉冲轮分析进行比较,以评估CO.
研究的目的:
- 为了比较来自动脉压波形 (脉冲轮分析) 的心脏输出 (CO) 测量结果,与来自动脉多普勒测量结果 (CBF).
- 评估这两种方法在经过重大选择性腹部手术后的患者之间的相关性.
- 确定CBF是否可以作为侵入性CO测量的替代品来预测流体响应.
主要方法:
- 一项前性观察性研究,涉及30名机械通风的大型选择性腹部手术后的成年患者.
- 血液动力学参数,包括通过动脉脉冲轮分析 (Vigileo/FloTrac) 和CBF的CO,在基线,被动前后腿部提升 (PLR) 和后液体玻尿酸记录下来.
- 使用PLR和标准化液体玻尿酸 (6ml/kg平衡盐溶液) 评估了液体反应.
主要成果:
- 维吉利奥和CBF都显示了PLR前后和液体后后的CO显著增加 (p<0.001).
- 在Vigileo和CBF测量的CO变化 (r=0.884) 在PLR前后之间观察到强烈的正相关性.
- 在所有记录时间点 (p<0.001) 中,两种技术的CO测量结果之间发现了显著的相关性.
结论:
- 动脉多普勒 (CBF) 测量显示,在手术后的患者中,心脏输出 (CO) 与脉冲轮分析 (Vigileo) 有显著的正相关性.
- CBF有可能作为侵入性CO监测的非侵入性替代品,以预测该患者亚组的液体反应.
- 建议进行进一步的大规模研究以验证这些发现.
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