在全身麻醉下进行重大腹部手术期间预测低血压的 perfusion index,pleth variability index和脉压变异性之间的比较:一项前性观察性研究
Satheesh Gunashekar1, Ashutosh Kaushal2, Ajit Kumar1
1Department of Anaesthesia, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Indian journal of anaesthesia
|April 8, 2024
概括
脉压变化 (PPV) 和充满变化指数 (PVI) 有效预测全身麻醉后的低血压. 在15分钟内预测低血压时,PPV和PVI的准确性高于输液指数 (PI).
科学领域:
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 生理学 生理学 生理学
背景情况:
- 在全身麻醉后的短期低血压可能会对手术结果产生不利影响.
- 在重大腹部手术期间,监测血液动力学稳定性至关重要.
- 预测低血压有助于及时干预和改善患者管理.
研究的目的:
- 为了比较变性指数 (PVI),脉冲压变性指数 (PPV) 和麻醉引起的低血压的输液指数 (PI) 的预测能力.
- 评估这些指标在预测全身麻醉后低血压的诊断性能.
主要方法:
- 一项涉及140名成人患者的观察性研究,这些患者在全身麻醉下接受了重大腹部手术.
- 在麻醉诱导后20分钟持续监测平均动脉压,心率,PVI,PPV和PI.
- 使用接收器操作特征 (ROC) 曲线进行分析,以确定预测准确度和最佳截止值.
主要成果:
- 低血压发生在36.4%的患者在5分钟内和45%的患者在诱导后15分钟内.
- PPV (AUROC 0.742) 和PVI (AUROC 0.717) 在5分钟内显示出显著的低血压预测潜力.
- 在15分钟后,PVI与PI和PPV相比,显示出更高的准确性,灵敏度,特异性和积极的预测值.
结论:
- PVI,PPV和PI可以在全身麻醉诱导5分钟内预测低血压.
- 与PI和PPV相比,PVI在15分钟标志上表现出较高的低血压的精度和预测值.
- 这些发现支持使用PVI和PPV作为监测麻醉期间血液动力学稳定的宝贵工具.
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