Pôle d'Anesthésie Réanimation, CHU de Lille, and EA 1046, Université Lille II, IMPRT-IFR 114, Lille, France.
Crit Care. 2011;15(2):134. doi: 10.1186/cc10074. Epub 2011 Mar 18.
Dynamic variables of fluid responsiveness are useful guides for fluid management in patients under controlled positive pressure ventilation. In the previous issue of Critical Care, Jacques and colleagues show that these variables remain reliable predictors of fluid responsiveness in a porcine model of intra-abdominal hypertension, but threshold values are higher than during normal intra-abdominal pressure. Their threshold values, however, cannot be applied to clinical practice. This study suggests that intra-abdominal pressure must be measured in critically ill patients, and 'supranormal' values of dynamic variables should be analyzed with caution. The 'fluid responsive part' of an increased dynamic variable in such patients may be estimated by measuring its change during a fluid challenge.
在接受控制正压通气的患者中，液体反应性的动态变量是液体管理的有用指导。在之前的《危重病医学》中，Jacques 及其同事表明，这些变量在腹腔内高压的猪模型中仍然是液体反应性的可靠预测指标，但阈值高于正常腹腔内压。然而，他们的阈值不能应用于临床实践。本研究表明，必须在危重病患者中测量腹腔内压，并且应该谨慎分析动态变量的“超正常”值。可以通过测量液体挑战期间其变化来估计此类患者中增加的动态变量的“液体反应部分”。
