Respirophasic carotid artery peak velocity variation as a predictor of fluid responsiveness in mechanically ventilated patients with coronary artery disease

医学 心脏病学 接收机工作特性 内科学 置信区间 冠状动脉疾病 脉冲压力 麻醉 血压
作者
Young Song,Young Lan Kwak,Jong Wook Song,Young Jin Kim,Jae‐Kwang Shim
出处
期刊:BJA: British Journal of Anaesthesia [Elsevier BV]
卷期号:113 (1): 61-66 被引量:68
标识
DOI:10.1093/bja/aeu057
摘要

BackgroundWe studied respirophasic variation in carotid artery blood flow peak velocity (ΔVpeak-CA) measured by pulsed wave Doppler ultrasound as a predictor of fluid responsiveness in mechanically ventilated patients with coronary artery disease.MethodsForty patients undergoing elective coronary artery bypass surgery were enrolled. Subjects were classified as responders if stroke volume index (SVI) increased ≥15% after volume expansion (6 ml kg−1). The ΔVpeak-CA was calculated as the difference between the maximum and minimum values of peak velocity over a single respiratory cycle, divided by the average. Central venous pressure, pulmonary artery occlusion pressure, pulse pressure variation (PPV), and ΔVpeak-CA were recorded before and after volume expansion.ResultsPPV and ΔVpeak-CA correlated significantly with an increase in SVI after volume expansion. Area under the receiver-operator characteristic curve (AUROC) of PPV and ΔVpeak-CA were 0.75 [95% confidence interval (CI) 0.59–0.90] and 0.85 (95% CI 0.72–0.97). The optimal cut-off values for fluid responsiveness of PPV and ΔVpeak-CA were 13% (sensitivity and specificity of 0.74 and 0.71) and 11% (sensitivity and specificity of 0.85 and 0.82), respectively. In a subgroup analysis of 17 subjects having pulse pressure hypertension (≥ 60 mm Hg), PPV failed to predict fluid responsiveness (AUROC 0.70, P=0.163), whereas the predictability of ΔVpeak-CA remained unchanged (AUROC 0.90, P=0.006).ConclusionsDoppler assessment of respirophasic ΔVpeak-CA seems to be a highly feasible and reliable method to predict fluid responsiveness in mechanically ventilated patients undergoing coronary revascularization.Clinical trial registrationNCT 01836081. We studied respirophasic variation in carotid artery blood flow peak velocity (ΔVpeak-CA) measured by pulsed wave Doppler ultrasound as a predictor of fluid responsiveness in mechanically ventilated patients with coronary artery disease. Forty patients undergoing elective coronary artery bypass surgery were enrolled. Subjects were classified as responders if stroke volume index (SVI) increased ≥15% after volume expansion (6 ml kg−1). The ΔVpeak-CA was calculated as the difference between the maximum and minimum values of peak velocity over a single respiratory cycle, divided by the average. Central venous pressure, pulmonary artery occlusion pressure, pulse pressure variation (PPV), and ΔVpeak-CA were recorded before and after volume expansion. PPV and ΔVpeak-CA correlated significantly with an increase in SVI after volume expansion. Area under the receiver-operator characteristic curve (AUROC) of PPV and ΔVpeak-CA were 0.75 [95% confidence interval (CI) 0.59–0.90] and 0.85 (95% CI 0.72–0.97). The optimal cut-off values for fluid responsiveness of PPV and ΔVpeak-CA were 13% (sensitivity and specificity of 0.74 and 0.71) and 11% (sensitivity and specificity of 0.85 and 0.82), respectively. In a subgroup analysis of 17 subjects having pulse pressure hypertension (≥ 60 mm Hg), PPV failed to predict fluid responsiveness (AUROC 0.70, P=0.163), whereas the predictability of ΔVpeak-CA remained unchanged (AUROC 0.90, P=0.006). Doppler assessment of respirophasic ΔVpeak-CA seems to be a highly feasible and reliable method to predict fluid responsiveness in mechanically ventilated patients undergoing coronary revascularization.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
传奇3应助明朗采纳,获得10
1秒前
1秒前
1秒前
2秒前
senhoo发布了新的文献求助10
2秒前
2秒前
小狗完成签到 ,获得积分10
3秒前
4秒前
4秒前
昏睡的实验室小白完成签到,获得积分10
5秒前
5秒前
yar应助大青山采纳,获得10
5秒前
Rondab应助mariawang采纳,获得10
5秒前
yqb发布了新的文献求助10
5秒前
5秒前
一条裸游的鱼完成签到,获得积分10
7秒前
二白关注了科研通微信公众号
7秒前
8秒前
8秒前
超帅听枫发布了新的文献求助10
8秒前
10秒前
10秒前
fish1116发布了新的文献求助100
10秒前
10秒前
bbbbb沫完成签到,获得积分20
10秒前
峥2发布了新的文献求助10
10秒前
wzy完成签到,获得积分10
10秒前
xxxllllll发布了新的文献求助10
11秒前
干净映天完成签到 ,获得积分10
11秒前
LJ_scholar发布了新的文献求助10
12秒前
kuny完成签到,获得积分10
12秒前
勤恳的夏之完成签到,获得积分20
13秒前
wzy发布了新的文献求助10
13秒前
钵钵鸡完成签到 ,获得积分10
13秒前
JING发布了新的文献求助10
13秒前
後zgw完成签到,获得积分10
15秒前
15秒前
16秒前
明朗发布了新的文献求助10
16秒前
meredith0571完成签到,获得积分10
17秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
‘Unruly’ Children: Historical Fieldnotes and Learning Morality in a Taiwan Village (New Departures in Anthropology) 400
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3988732
求助须知:如何正确求助?哪些是违规求助? 3531027
关于积分的说明 11252281
捐赠科研通 3269732
什么是DOI,文献DOI怎么找? 1804764
邀请新用户注册赠送积分活动 881869
科研通“疑难数据库(出版商)”最低求助积分说明 809021