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在非心脏手术期间使用动态预负载指数评估体积响应的潮体积挑战:一项前性研究

Panagiota Griva¹, Emmanouil I Kapetanakis², Orestis Milionis¹

¹Second Department of Anesthesiology, Attikon University Hospital, National and Kapodistrian University of Athens, 12461 Athens, Greece.

Journal of clinical medicine

|January 11, 2025

概括

在潮体积挑战 (VtC) 后,脉冲压变化 (PPV) 和中风体积变化 (SVV) 的变化可以预测手术患者的液体反应. 一个 ΔPPV ((6-8) 或 ΔSVV ((6-8) 增加超过 2% 准确识别的流体反应者.

科学领域:

麻醉学麻醉学
关键护理医学关键护理医学
心血管生理学心血管生理学

背景情况:

评估流体反应对于在全身麻醉和保护性机械通风的患者至关重要.
预测液体反应率指导适当的液体管理,优化血液动力学稳定性.

研究的目的:

评估潮体积挑战 (VtC) 后脉冲压变化 (PPV) 和冲击体积变化 (SVV) 的变化是否可以预测流体响应.
为了确定VtC在预测手术患者对液体给药反应的疗效.

主要方法:

招募了40名接受保护性机械通风手术的患者.
潮体积从6升至8毫升/千克IBW (VtC),PPV和SVV在前后进行测量.
进行液体扩张,并通过中风体积指数 (SVI) 的变化来评估液体反应.

主要成果:

ΔPPV(6-8) >2%的预测流体反应率,具有83%的灵敏度和73%的特异性 (AUC=0.86).
ΔSVV(6-8) >2%的预测流体反应率,具有83%的灵敏度和77%的特异性 (AUC=0.82).
这两个参数都显示出显著的预测能力 (p < 0.0001).

结论:

潮体积挑战 (VtC) 是预测手术患者的液体反应的宝贵工具.
在VtC之后的PPV和SVV的变化为指导流体治疗提供了可靠的指标.

关键词:

流体响应度流体响应度血液动力学指数的指数没有回应的非响应者.脉冲压力变化的变化响应者响应者响应者脑中风的体积变化脑中风体积变化潮体积挑战潮体积挑战

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