毛细血管补充时间作为接受血管活性治疗的重症患者常规体检的一部分:一项前性研究
Fabian Wesołek1, Zbigniew Putowski2, Wiktoria Staniszewska1
1Students' Scientific Society, Department of Acute Medicine, School of Medicine in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland.
Journal of clinical medicine
|October 16, 2024
概括
毛细血管补充时间 (CRT) 在重症患者中提供了超越平均动脉压 (MAP) 和乳酸水平的宝贵血液动力学见解. 这种输液标记物可以在初始复苏努力后补充常规评估.
科学领域:
- 关键护理医学 关键护理医学
- 血液动力学 血液动力学
- 生理学 生理学 生理学
背景情况:
- 达到65mmHg的平均动脉压 (MAP) 是重症患者组织氧化的复苏目标.
- 一些患者无法从固定的MAP目标中获益,因此需要额外的血液动力学评估工具.
- 毛细血管补充时间 (CRT) 是对外周 perfusion 的已确定的标志物,但其与其他血液动力学变量一起的实用性需要进一步研究.
研究的目的:
- 调查CRT是否在重症患者的复苏后提供独立的血液动力学信息.
- 评估CRT和其他容易获得的血液动力学变量之间的关系,包括MAP,乳酸和血管压缩剂剂量.
主要方法:
- 对接受机械通风,血管压缩器治疗的重症患者进行前性研究.
- 同时评估CRT,MAP,以及与北上腺素相当剂量 (NEDs).
- 分析使用斯皮尔曼的等级相关性.
主要成果:
- 在CRT和MAP (R = -0.1,p = 0.14) 或乳酸 (R = 0.11,p = 0.13) 之间没有发现显著的相关性.
- 在CRT和NED之间观察到微弱的正相关性 (R = 0.25,p = 0.0005).
- 在低血压患者中,83%的CRT正常,尽管使用了血管压缩剂;在高剂量的血管压缩剂患者中,58%的CRT正常,MAP>65mmHg.
结论:
- 毛细血管补充时间 (CRT) 提供了独立于MAP,乳酸和血管压缩剂剂量的血液动力学信息.
- 在重症患者中,CRT可以提供对外周 perfusion 的额外见解.
- 可以将CRT整合到患者的常规体检中,超越初始复苏阶段.
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