在肺切除中用于液体管理的被动腿部提升的终潮CO2反应:一种随机对照试验
Havva Suheyla Akin Uzan1, Lale Yuceyar2, Nevzat Cem Sayilgan3
1Havva Suheyla Akin Uzan, Department of Anesthesiology and Reanimation, Edirne State Hospital, Saglik Mah. Dr. Sadık Ahmet Cad. No: 8, 22030, Edirne, Turkiye. Department of Anesthesiology and Reanimation, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, Fatih, 34098, Istanbul, Turkiye.
Pakistan journal of medical sciences
|December 26, 2025
概括
在被动腿部提升 (PLR) 后,终潮二氧化碳 (EtCO2) 的变化可以预测肺切除手术患者的液体反应. 这种非侵入性方法可以指导液体治疗,并改善脏结果.
科学领域:
- 麻醉学 麻醉学
- 临界护理医学 临界护理医学
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 液体反应能力的评估在胸部手术中至关重要.
- 在外科手术期间预测流体需求可以优化患者的治疗结果.
- 对流体管理的非侵入性方法是非常可取的.
研究的目的:
- 确定被动腿部升高 (PLR) 后的终潮二氧化碳 (EtCO2) 变化是否预测肺切除手术 (LRS) 患者的液体反应.
- 在这个患者群体中评估EtCO2引导液体治疗的效用.
主要方法:
- 一项前性随机对照试验,涉及50名接受选择性LRS的患者.
- 在PLR前后测量EtCO2;≥2 mmHg的增加定义了响应能力.
- 响应者被随机分配到液体玻尿酸或维持液体;未响应者接受了维持液体.
主要成果:
- 62%的患者是流体反应者.
- 液体玻尿酸组没有急性损伤 (AKI),与对照组和非响应组不同.
- 手术后尿素水平在对照组显著增加.
结论:
- 在PLR后的EtCO2变化可以作为胸部外科手术中液体反应的简单,非侵入性预测器.
- 在反应良好的患者中,有针对性的液体注射可能会增强脏保护.
- 需要进一步的研究来证实这些发现.
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