决策支持指导流体挑战和高风险手术期间的中风体积反应:随机对照试验的后期分析
Sean Coeckelenbergh1,2, Joseph Rinehart1, Olivier Desebbe3
1Department of Anaesthesiology & Perioperative Care, University of California Irvine, Irvine, CA, 92868, USA.
Journal of clinical monitoring and computing
|January 18, 2025
概括
与临床医生发起的液体挑战相比,Acumen辅助流体管理 (AFM) 系统在高风险手术期间改善了流体响应能力. 由AFM引导的液体挑战导致了更大的中风体积增加,优化了液体的管理.
科学领域:
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 血液动力学 血液动力学
背景情况:
- 在高风险手术期间,静脉注射液体对优化中风体积 (SV) 至关重要.
- 液体挑战技术通过评估血液动力学反应来评估对液体的需求.
- 敏辅助流体管理 (AFM) 系统是流体管理的决策支持工具.
研究的目的:
- 为了比较AFM引导和临床医生启动的流体挑战之间的流体响应率.
- 评估AFM对高风险手术中中风体积优化的影响.
主要方法:
- 随机对照试验后期分析,该试验涉及85名接受高风险腹部手术的患者.
- 患者在5分钟内接受250毫升液体 (晶体或白蛋白) 的注射.
- 流体挑战要么是以AFM为指导,要么是临床医生发起的.
主要成果:
- 流体反应率的中位数在AFM组 (50%) 与对照组 (33%) 相比显著更高 (p<0.001).
- 平均中风体积增加在AFM引导的挑战 (12%) 与临床医生发起的挑战 (6%) (p<0.001) 中较大.
- 由AFM启动的液体挑战更频繁地与所需的SV增加有关.
结论:
- 在高风险手术期间,AFM引导的液体挑战在实现液体反应和增加中风体积方面更有效.
- 该AFM系统增强了液体输送策略,潜在地改善了患者的治疗结果.
相关概念视频
Regulation of Stroke Volume
2.8K
The regulation of stroke volume, which is the amount of blood the heart pumps out during each heartbeat, is critical for maintaining a healthy circulatory system. Stroke volume is influenced by three main factors: preload, contractility, and afterload.
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling...
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling...
2.8K
Cardiac Output II: Effect of Stroke Volume on Cardiac Output
505
Cardiac output (CO), the amount of blood the heart pumps per minute, is a parameter in cardiovascular physiology determined by stroke volume and heart rate. Stroke volume, the amount of blood pushed from one of the ventricles per heartbeat, is influenced by preload, afterload, and contractility.
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...
505
Pre-Procedural Guidelines for Assessing Blood Pressure
509
Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the...
509


