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Benjamin Drum¹, Bryce La Course¹, Mark Kelly¹

¹Department of General Internal Medicine, University of Utah, Salt Lake City.

|February 23, 2026

概括

在非输管患者中,可以使用特定的临床,放射和实验室发现来准确评估血管内体积过载. 血大脑类型尿素 (BNP) 水平和胸部X射线图是关键指标.

科学领域:

心脏病学心脏病学
临界护理医学临界护理医学
诊断成像诊断成像诊断成像

背景情况:

准确评估血管内体积对于管理液体平衡至关重要,特别是在体积过载的患者中.
确定可靠的体积过载诊断方法对于及时有效的患者管理至关重要.

研究的目的:

确定最准确的临床检查,放射和实验室发现,以评估非输管患者的血管内体积过载.
评估各种方法的诊断准确性,以识别体积过载患者.

主要方法:

为了确定相关的英语研究,对MEDLINE (1946年至2026年1月6日) 进行了系统的文献搜索.
数据提取包括灵敏度,特异性和概率比率 (LRs),估计使用2级混合后勤回归模型进行聚合.
该分析包括了40项涉及11,490名成年患者的研究.

主要成果:

状静脉膨胀 (LR,4.1),下肢胀 (LR,2.2) 和裂 (LR,2.7) 是体积过载的迹象.
胸部X射线图 (LR,5.9) 和双边肺B线 (LR,4.0) 的血管堵塞增加了体积过载的可能性.
血大脑类型尿酸 (BNP) 水平≥100 ng/mL是最强的指标 (LR,6.9),而无肺B线 (LR,0.09) 和BNP<100 ng/mL是排除的有用指标.

结论:

血BNP水平≥100 ng/mL和血管拥堵的胸部X光学发现对于诊断体积过载非常有用.
在护理点超声学上没有肺B线或BNP水平<100 ng/mL可以有效排除体积过载.
这些发现有助于临床医生在怀疑体积过载的患者中做出有关流体管理的明智决定.

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