使用人工智能设备来评估复杂的大型整形外科手术过程中的血液损失
Leo A Whiteside1, Marie E Roy1
1Missouri Bone and Joint Center, Missouri Bone and Joint Research Foundation, St. Louis, Missouri.
The Journal of arthroplasty
|May 5, 2024
概括
补偿储备指数 (CRI) 监测可以预测骨科手术患者的输血需求和紧急护理. 这种由人工智能驱动的工具提供了比标准生命体征更敏感的心血管容量的测量.
科学领域:
- 心血管生理学心血管生理学
- 人工智能在医学中的应用
- 手术患者监测手术患者监测
背景情况:
- 补偿储备指数 (CRI) 来自脉冲氧仪波形分析,量化剩余的心血管容量.
- 对于检测血液损失,CRI比传统的生命体征更为敏感和特异.
- 这项研究研究了CRI在预测主要骨科手术患者心血管储备中的实用性.
研究的目的:
- 测试CRI可以预测在接受重大骨科手术的患者中储备心血管容量的损失的假设.
- 评估CRI在帮助这些患者管理方面的潜力,特别是在输血和输血需求方面.
主要方法:
- 304名接受下肢关节整形手术的患者被纳入波形监测.
- 脉冲氧计波形通过指尖探针捕获并使用平板电脑处理.
- 在整个外科手术期间,持续监测心血管回血率,静脉血压和心率.
主要成果:
- 在CRI测量中,显著发现了患有输血和紧急医疗护理风险较高的患者 (P = .000021).
- 致病性肥胖患者的低CRI和临床事件发生率较高.
- 使用0.40的CRI值以追溯保留输血导致该亚组的整体输血率更高.
结论:
- CRI监测可以识别有输血和紧急医疗干预风险的骨科手术患者.
- 在主要的骨科手术中,CRI可能有助于优化血液损失管理和输血策略.
- 与CRI相比,标准生命体征 (压缩血压,心率) 是输血需求的较不有效预测因素.
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