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[全身麻醉期间血流动力学变化的逻辑模型评估]

[Assessment by logistic model of hemodynamic changes during general anesthesia].

作者信息

Mizuno Ju, Tsuda Takeshi, Otsuji Mikiya, Arita Hideko, Hanaoka Kazuo

机构信息

Molecular Cardiology Laboratory, Nemours Biomedical Research, Alfred I. duPont Hospital for Children, Wilmington, Delaware 19803, USA.

出版信息

Masui. 2008 Mar;57(3):341-51.

Abstract

The anesthesia induction with strong anesthetic agents generally reduces blood pressure. Cardiovascular agents used during anesthesia induce hemodynamic changes. The time courses of systolic (sBP) and diastolic blood pressure (dBP) and heart rate (HR) are expressed as sigmoidal curve. We have found that the hemodynamic changes can be precisely curve-fitted with a logistic function giving non-linear curve. The four parameters of the logistic function present the first asymptote, the last asymptote, the slope at the inflection point, and the time to the inflection point. Moreover, each logistic parameter is used for the effects of drug dose, age and sex differences of subjects on the hemodynamic change. In this review, we introduce the analyses with the logistic function for the changes in sBP, and dBP during preintubation period and HR, sBP, and dBP during infusion of landiolol hydrochloride, an ultra-short-acting beta1-adrenergic receptor blocking agent, which is used for subjects with tachycardia during general anesthesia. The logistic parameters are useful for assessing the hemodynamic response during general anesthesia. The assessment method of the hemodynamic change using the logistic model contributes much to the management of anesthesia.

摘要

使用强效麻醉剂进行麻醉诱导通常会降低血压。麻醉期间使用的心血管药物会引起血流动力学变化。收缩压(sBP)、舒张压(dBP)和心率(HR)的时间进程表现为S形曲线。我们发现,血流动力学变化可以用给出非线性曲线的逻辑函数精确地进行曲线拟合。逻辑函数的四个参数分别表示第一渐近线、最后渐近线、拐点处的斜率以及到达拐点的时间。此外,每个逻辑参数用于研究药物剂量、受试者年龄和性别差异对血流动力学变化的影响。在本综述中,我们介绍了使用逻辑函数对插管前期sBP和dBP的变化以及在输注超短效β1肾上腺素能受体阻滞剂盐酸兰地洛尔期间HR、sBP和dBP的变化进行的分析,盐酸兰地洛尔用于全身麻醉期间心动过速的患者。逻辑参数有助于评估全身麻醉期间的血流动力学反应。使用逻辑模型评估血流动力学变化的方法对麻醉管理有很大帮助。

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