每搏輸出量變異評(píng)估腹腔高壓家豬液體反應(yīng)性的有效性
發(fā)布時(shí)間:2018-04-22 01:18
本文選題:腹腔高壓 + 每搏輸出量變異; 參考:《臨床麻醉學(xué)雜志》2017年08期
【摘要】:目的探討每搏輸出量變異(SVV)評(píng)價(jià)不同腹腔高壓家豬液體反應(yīng)性的有效性。方法選擇實(shí)驗(yàn)家豬40只,經(jīng)頸動(dòng)脈釋放家豬30%血容量,維持家豬低血容量狀態(tài),并按隨機(jī)數(shù)字表法隨機(jī)分為四組,采用氮?dú)鈿飧狗ǚ謩e維持腹腔壓力(IAP)為0 mm Hg(L0組)、15 mm Hg(L15組)、25mm Hg(L25組)和35mm Hg(L35組),穩(wěn)定30min后給予HES 500 ml液體復(fù)蘇,采用脈搏輪廓持續(xù)心輸出量監(jiān)測(cè)(PiCCO)法分別于基線水平、低血容量模型建立后、液體復(fù)蘇后測(cè)家豬SVV以及液體復(fù)蘇前后每搏輸出量(SV)。結(jié)果 L0組和L15組家豬SVV與SV呈明顯正相關(guān)(r分別為0.888和0.942,P0.05),而L25組和L35組SVV與SV均無(wú)明顯相關(guān)性(r分別為0.068和-0.114)。結(jié)論 IAP輕度升高(IAP≤15mm Hg)時(shí),SVV可作為評(píng)估液體反應(yīng)性的有效指標(biāo),重度腹腔高壓(IAP≥25mm Hg)時(shí),SVV不能有效評(píng)估液體反應(yīng)性。
[Abstract]:Objective to evaluate the effectiveness of SVV in evaluating fluid reactivity in pigs with different abdominal hypertension. Methods 40 domestic pigs were selected to release 30% blood volume through carotid artery to maintain hypovolemic state and were randomly divided into four groups according to random digital table method. The abdominal pressure was maintained by nitrogen pneumoperitoneum (0 mm Hg(L0 group, 15 mm Hg(L15 group, 25 mm Hg(L25 group) and 35mm Hg(L35 group. After 30min was stabilized, HES 500ml fluid was resuscitated, and the pulse contour continuous cardiac output monitoring was used to measure the baseline level. After the establishment of hypovolemic model, SVV was measured after fluid resuscitation and the output volume per stroke was measured before and after fluid resuscitation. Results the positive correlation between SVV and SV in L0 group and L15 group was 0.888 and 0.942 (P 0.05), respectively, while there was no significant correlation between SVV and SV in L25 and L35 groups (0.068 and -0.114), respectively. Conclusion IAP can be used as an effective index for evaluating fluid reactivity when IAP is slightly elevated and 25mm Hg鈮,
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