作为流体反应的预测指标的上腔静脉缩性指数:一个系统性审查与元分析
Tomasz Królicki1, Maciej Molsa1, Andrzej Tukiendorf2
1Department of Anesthesiology and Intensive Care, Institute of Medical Sciences, University of Opole, Poland.
Anaesthesiology intensive therapy
|October 25, 2024
概括
上 vena cava 折叠性指数 (SVC-CI) 可靠地预测机械通风患者的液体反应. 然而,高的阳性末端呼气压 (PEEP) 水平可能会降低它的准确性.
科学领域:
- 关键护理医学 关键护理医学
- 心血管生理学心血管生理学
- 机械通风机械通风机械通风
背景情况:
- 上 vena cava 折叠性指数 (SVC-CI) 是机械通风患者流体响应 (FR) 的潜在指标.
- 目前对其诊断性能存在有限的研究.
研究的目的:
- 系统地评估SVC-CI的诊断性能,作为机械通风成年患者中FR的标志物.
主要方法:
- 在Medline和EMBASE上进行了遵循PRISMA指南的系统文献搜索.
- 包含的前性研究评估了在通风成年人中的SVC-CI;一个双变的随机效应模型生成了收容器运行特征 (SROC) 总结曲线.
- 在ROC曲线下的计算面积 (AUC),灵敏度和特异性.
主要成果:
- 分析了包括857名患者在内的8项研究,其中有1083项SVC-CI评估.
- 在56.23%的病例中,FR存在. SROC曲线显示灵敏度为80.8%,特异性为81.4%.
- 该AUC为0.848 (P<0.001),没有显著的研究间异质性. 较高的PEEP水平 (> 5厘米H2O) 显著降低了灵敏度 (P = 0.0207).
结论:
- 在重症监护和手术室设置中,SVC-CI是FR的可靠预测器.
- 较高的PEEP水平 (>5厘米H2O) 可能会影响测试的灵敏度.
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