潮体积挑战测试在体积响应性评估中的作用:叙述性综述
Panagiota Griva1, Christina Talliou1, Eleftheria Soulioti1
12nd Department of Anesthesiology, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, 12461, Greece.
Journal of anesthesia, analgesia and critical care
|July 2, 2025
概括
潮体积挑战准确地预测了接受手术的患者的液体反应. 这种方法通过增加潮体积和监测血液动力学变化来增强液体的管理,改善患者的治疗结果.
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:
- 准确的液体管理对于在手术期间的目标导向治疗至关重要,可以预防高血症或低血症的并发症.
- 使用减少潮体积 (低于8毫升/kg理想体重) 的肺保护性通风策略现在是标准的,但它们损害了预测流体响应性的动态指数 (如脉冲压变化) 的可靠性.
研究的目的:
- 评估潮体积挑战的有效性,作为预测患者流体反应的方法.
- 为了确定潮体积挑战是否提高了流体响应性预测的准确性,而不是在肺防护通风下使用传统方法.
主要方法:
- 潮体积挑战涉及暂时增加潮体积从理想体重的6到8毫升/公斤.
- 血液动力学参数,包括脉冲压力变化和脉冲体积变化,在潮体积增加期间进行监测.
- 增加的潮体积对这些血液动力学参数的影响被分析,以预测流体的响应性.
主要成果:
- 潮体积挑战在涉及手术和重症患者的多项研究中得到了验证.
- 这种方法通过增加灵敏度和特异性,显著提高了预测流体响应的准确性.
- 对于脉冲压变化和脉冲体积变化的确定的值提供了精确的临床指导.
结论:
- 潮体积挑战是预测流体响应性的可靠方法,特别是在采用肺保护通风策略时.
- 需要进一步的临床队列和随机对照试验来巩固潮体积挑战在优化流体管理策略中的作用.
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