肠道准备后进行结肠镜检查的患者的液体反应和低血压:前性队列研究
Megan L Allen1,2,3, Michael Kluger4, Frank Schneider4
1Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, VIC, Australia. megan.allen@mh.org.au.
接受结肠镜检查的患者经常经历液体枯竭,增加低血压风险. 在评估体积状态方面,胸外回声心脏成像 (TTE) 比ClearSight监测更可靠.
科学领域:
- 心脏病学 心脏病学
- 胃肠病学 胃肠病学
- 麻醉学 麻醉学
背景情况:
- 在接受结肠镜检查的患者中,禁食和肠道准备可以导致血管内体积耗尽.
- 临床后果和体积耗尽的严格证明往往缺乏.
- 这项研究研究了体积状况及其与结肠镜检查期间手术内低血压的关系.
研究的目的:
- 探索血管内体积状态和手术内低血压之间的关系.
- 在评估血管内体积状态时,比较TTE和ClearSightTM非侵入性心脏输出监测器.
- 为了确定在接受结肠镜检查的患者中流体反应的发生率.
主要方法:
- 招募了接受选择性结肠镜检查的成年患者.
- 使用TTE和ClearSight测量评估了程序前的体积状态.
- 术内低血压被定义为平均动脉压<60 mm Hg;主要结局是通过TTE被动腿抬起测试来减小体积.
主要成果:
- 32%的患有足够的TTE图像的患者表现出体积枯竭的迹象.
- 对于中风体积测量,TTE和ClearSight之间的一致性很差.
- 与正常血压患者 (21%) 相比,对液体有反应的患者出现显著的手术内低血压的发生率更高 (48%).
结论:
- 在肠道准备后接受结肠镜检查的患者经常对液体有反应.
- 响应液体的患者有较高的风险出现显著的手术内低血压.
- 胸外回声心脏成像仍然是一个比ClearSight监测更可靠的方法来评估体积状态.
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