控制性肺膨胀时血流动力学指标对ARDS机械通气患者容量反应性的预测价值

发布时间：2019-07-25 09:21

【摘要】：目的:探讨控制性肺膨胀(SI)对急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)机械通气患者容量反应性的预测价值。方法:将2016年3月至12月在丹阳市人民医院重症医学科行机械通气的ARDS患者纳入研究。监测患者SI前后的血流动力学变化,15 min进行补液试验(FC),根据心指数变化值(ΔCI)将其分为有容量反应性组(FR组,ΔCI≥10%)和无容量反应性组(NFR组,ΔCI10%)。统计学分析SI时可预测容量反应性的指标,并评估其诊断价值。结果:本研究共纳入40例患者(FR组22例,NFR组18例)。与SI前相比,FR组SI后CI(2.90±0.24 vs 2.61±0.24)、收缩压(SBP)[(102.4±8.0)mm Hg vs(94.0±8.6)mm Hg]差异均有统计学意义(P0.05)。SI-ΔCI、SI-ΔSBP评估容量反应性的ROC分别为0.934、0.851,敏感度均为90.9%,特异度分别为88.9%、77.8%。结论:SI-ΔCI、SI-ΔSBP可用于评估ARDS机械通气患者的容量反应性。
[Abstract]:Objective: to evaluate the predictive value of controlled pulmonary dilatation (SI) in patients with acute respiratory distress syndrome (acute respiratory distress syndrome,ARDS) mechanical ventilation. Methods: from March to December 2016, ARDS patients undergoing mechanical ventilation in the Department of severe Medicine, Danyang people's Hospital were included in the study. The hemodynamic changes before and after SI were monitored. 15 min rehydration test (FC), was divided into volume reactive group (FR group, 螖 CI 鈮，

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