使用脉冲压变化的目标导向液体疗法在需要单肺通风的胸部手术中:一项随机对照试验
Giovanni Punzo1, Giovanna Beccia1, Chiara Cambise1
1Department of Emergency, Anesthesiological and Reanimation Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.
Journal of clinical medicine
|September 28, 2024
概括
在胸部手术中使用脉冲压变化 (PPV) 进行流体管理并没有改善氧气水平或减少并发症. 与标准方法相比,这种方法导致增加液体的使用,但没有明显的临床益处.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 临界护理医学 临界护理医学
背景情况:
- 术内流体管理策略对于手术结果至关重要.
- 脉冲压变化 (PPV) 在优化流体管理方面表现有前途.
- 它在一个肺通风的胸部手术中的作用仍然未确立.
研究的目的:
- 评估PPV引导流体管理的有效性和安全性.
- 为了比较PPV引导的流体管理与胸部手术中的传统方法.
- 评估对肺气交换和术后并发症的影响.
主要方法:
- 随机试验比较PPV引导的流体管理与传统的血液动力学参数.
- 单门视频辅助胸部手术用于肺叶切除术.
- 主要结局:排泄后的氧气部分压力/吸入氧气 (PaO2/FiO2) 分数的比率.
主要成果:
- 两组之间PaO2/FiO2比率没有显著差异 (p=0.51).
- PPV组接受的晶化物 (p=0.01) 和合物 (p=0.002) 显著更多.
- 输出时间,术后肺部并发症或住院时间没有差异.
结论:
- 在胸部外科手术中,PPV引导的流体管理不能增强肺气交换.
- 这种策略似乎没有比传统的流体管理提供临床益处.
- 以PPV为指导的管理导致液体的摄入量增加.
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