潮体积挑战期间内静脉呼吸变化的变化预测在保护性通风下腰部手术中的体积响应:一项前性队列研究
Mimi Wu1, Jie Xu2, Xiaojie Liu1
1Department of Anesthesiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, People's Republic of China.
Journal of intensive care
|October 1, 2025
概括
潮体积挑战 (TVC) 改善了内静脉呼吸变异 (IJVV) 对易患病患者流体反应的评估. 这种方法在低潮量通风时比传统的IJVV,PPV和SVV更可靠.
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:
- 内静脉呼吸变异 (IJVV) 是一种流体响应的动态预测指标.
- 它的有效性在接受低潮流体积 (Vt) 通风的易感患者中是有限的.
- 潮体积挑战 (TVC) 涉及暂时增加Vt以提高IJVV可行性.
研究的目的:
- 评估TVC是否增强IJVV预测流体响应能力的能力.
- 评估TVC在接受低Vt通风后腰部手术的患者的可行性.
- 为了比较TVC修改IJVV与传统IJVV,PPV和SV的诊断性能.
主要方法:
- 在手术室进行前性研究.
- 在基线Vt (6毫升/公斤PBW) 和TVC (8毫升/公斤PBW) 期间测量IJVV,PPV和SVV.
- 通过Trendelenburg演习期间心脏指数的变化来评估液体反应 (ΔCI趋势> ≥8%).
主要成果:
- ΔIJVV6-8在预测体积响应性方面表现出高准确度 (AUC 0.96).
- 对 ΔIJVV6-8 的敏感度为96.77%,特异性为86.67%.
- ΔIJVV6-8显示AUC显著高于基线IJVV6,PPV6和SVV6.
结论:
- 在TVC期间IJVV的变化有效预测后腰部手术患者的体积响应.
- 在这种特殊的手术环境中,这种方法比IJVV,PPV和SVV更可靠.
- TVC增强了IJVV在低Vt通风设置中的流体管理中的实用性.
相关概念视频
Respiratory Volumes
2.8K
Respiratory volumes are crucial metrics, meticulously measured to quantify the air exchanged in and out of the lungs during various phases of the breathing cycle. These precise measurements are vital for assessing lung function, diagnosing respiratory conditions, and monitoring overall respiratory health. Each parameter provides specific insights into the mechanics of breathing and the functional capacity of the lungs.
Tidal Volume (TV) Tidal volume (TV) is the air inhaled or exhaled in a...
Tidal Volume (TV) Tidal volume (TV) is the air inhaled or exhaled in a...
2.8K
Assessment of Ventilation II: Respiratory Depth and Rhythm
2.4K
Respiratory Depth
Respiratory depth measures the volume of air inhaled or exhaled during a breath. It can vary from shallow to deep and typically remains consistent when a person is at rest or asleep. Occasionally, individuals will automatically inhale deeply, known as sighing, which inflates the lungs with more air than normal breathing.
To assess respiratory depth, observe the degree of chest excursion or movement:
Respiratory depth measures the volume of air inhaled or exhaled during a breath. It can vary from shallow to deep and typically remains consistent when a person is at rest or asleep. Occasionally, individuals will automatically inhale deeply, known as sighing, which inflates the lungs with more air than normal breathing.
To assess respiratory depth, observe the degree of chest excursion or movement:
2.4K
Assessment of Ventilation I: Respiratory Rate
1.9K
Assessment of Ventilation
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
1.9K
Respiratory Volumes and Capacities
4.9K
The respiratory system is responsible for the intake of oxygen and the expulsion of carbon dioxide from the body. Respiratory volumes describe the volume of air in the lungs at different phases of the respiratory cycle. Tidal volume is the air breathed in and out during normal, quiet breathing. Inspiratory reserve volume is the air that can be forcefully inspired beyond the tidal volume. In contrast, expiratory reserve volume refers to the air that can be expelled from the lungs after a normal...
4.9K
Respiratory Volumes and Capacities I
1.6K
Assessing the respiratory rate and rhythm for a complete minute is crucial for evaluating the breathing pattern. Even a minor increase in the patient's average respiratory rate, by as little as three to five breaths per minute, is an early and vital indicator of respiratory distress. Patients with a respiratory rate exceeding twenty-four breaths per minute require close monitoring to determine the physiological alterations. This careful observation is essential for prompt recognition and...
1.6K
Pulmonary Ventilation: Inhalation
7.5K
Pulmonary ventilation is a vital process that ensures the exchange of oxygen and carbon dioxide in the lungs. It refers to the movement of air into and out of the lungs, enabling the body to obtain oxygen and remove waste carbon dioxide. In this article, we will explore the intricacies of pulmonary ventilation, including its underlying principles, mechanisms, and the interplay of pressures within the respiratory system.
Boyle's law becomes particularly pertinent when examining respiratory...
Boyle's law becomes particularly pertinent when examining respiratory...
7.5K


