低血压预测指数软件与接受大动脉手术的患者的标准高级血液动力学监测相比:一项回顾性研究
Jakub Szrama1, Mariusz Gezela2, Łukasz Żurański2
1Department of Anaesthesiology, Intensive Therapy and Pain Management, Poznan University of Medical Sciences, 60-355 Poznan, Poland.
Journal of clinical medicine
|December 30, 2025
概括
低血压预测指数 (HPI) 监测在大动脉手术期间没有显著降低手术内低血压. 虽然趋势表明低血压减少,但HPI使用导致高血压增加,这表明需要仔细进行干预定位.
科学领域:
- 麻醉学 麻醉学
- 心血管外科心血管外科
- 医疗技术 医疗技术 医学技术
背景情况:
- 术内低血压 (IOH) 与主要血管手术中的术后并发症有关.
- 低血压预测指数 (HPI) 是一项旨在预测和预防IOH的技术.
- 将HPI与动脉压心脏输出 (APCO) 监测进行比较,对于优化血液动力学管理至关重要.
研究的目的:
- 为了比较HPI和APCO监测的患者之间的手术内血动力学稳定性.
- 评估HPI在大动脉手术期间降低低血压的有效性.
- 评估HPI对低血压和高血压发作的影响.
主要方法:
- 对100名接受选择性大动脉手术的成年患者进行了回顾性研究.
- 50名患者使用APCO进行监测,50名患者使用HPI算法进行监测.
- 主要终点:时间加权的平均动脉压低于65mmHg;次要终点:低血压/高血压持续时间和频率.
主要成果:
- 在HPI和APCO组之间,时间加权平均动脉压低于65mmHg的平均动脉压没有显著差异.
- 趋势表明,HPI组的总低血压时间和发作持续时间较短 (未经校正的p=0.03).
- 在HPI组经过修正后 (调整=0.036),平均动脉压升高 (>90 mmHg和>100 mmHg) 的时间显着更长.
结论:
- 在多次比较纠正后,HPI监测没有显著减少大动脉手术中的低血压负担.
- 使用HPI与增加高血压暴露有关,这表明过于积极的管理.
- 需要进一步的前性研究来评估使用预测算法对干预措施的仔细定位.
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