在健康成年人血液动力学操作后脉冲波传输时间的变化:前性随机观察试验 (PWTT志愿者研究)
Johannes M Wirkus1, Fabienne Goss1, Matthias David2
1Department of Anaesthesiology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
BJA open
|July 19, 2024
概括
脉冲波传输时间 (PWTT) 可以监控流体状态,显示预加载变化的即时变化. 然而,晚期的PWTT变化可能不反映流体转移,限制了临床使用.
科学领域:
- 心血管生理学心血管生理学
- 医疗监控技术 医疗监控技术
背景情况:
- 脉冲波传输时间 (PWTT) 是一种有前途的非侵入性方法,用于在手术期间监测血管内液体状态.
- 目前对PWTT如何反映主要的血液动力学变量,如预负荷,内和后负荷的理解是有限的.
研究的目的:
- 调查PWTT和血液动力学变量之间的关系,这些变量代表预负荷,内托普和后负荷.
- 评估PWTT在临床环境中实时血液动力学监测的潜力.
主要方法:
- 在24名成年志愿者中进行了连续PWTT测量.
- 脑中风的体积是通过 transthoracic 心脏回声学来评估的.
- 志愿者进行了改变预负荷 (站立,被动抬起腿部),内托普 (步骤测试) 和胸内压力 (瓦尔萨尔瓦机动) 的机动.
主要成果:
- 立即的PWTT增加与"站起来"机动期间的中风体积减少相关 (P<0.0001).
- 立即PWTT下降与被动抬腿期间中风体积增加相关 (P=0.0024).
- "步骤测试"没有显示PWTT的立即变化,但显著的晚期增加 (P<0.0001);瓦萨尔瓦机动产生了异质的结果.
结论:
- 非侵入性PWTT评估有效地检测到健康成年人的即时预加载变化.
- 由于与流体转移无关的延迟变化,PWTT的临床实用性可能受到限制.
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