Department of Surgery, Nanjing University School of Medicine, Nanjing, China.
Anaesthesia. 2012 Jul;67(7):777-83. doi: 10.1111/j.1365-2044.2012.07117.x. Epub 2012 Mar 27.
This systematic review and meta-analysis assessed the accuracy of plethysmographic variability index derived from the Massimo(®) pulse oximeter to predict preload responsiveness in peri-operative and critically ill patients. A total of 10 studies were retrieved from the literature, involving 328 patients who met the selection criteria. Overall, the diagnostic odds ratio (16.0; 95% CI 5-48) and area under the summary receiver operating characteristic curve (0.87; 95% CI 0.78-0.95) for plethysmographic variability index to predict fluid or preload responsiveness was very good, but significant heterogeneity existed. This could be explained by a lower accuracy of plethysmographic variability index in spontaneously breathing or paediatric patients and those studies that used pre-load challenges other than colloid fluid. The results indicate specific directions for future studies.
本系统评价和荟萃分析评估了 Massimo（®）脉搏血氧仪衍生的容积描记变异指数预测围手术期和危重症患者前负荷反应性的准确性。从文献中检索到 10 项研究，共纳入符合选择标准的 328 名患者。总体而言，容积描记变异指数预测液体或前负荷反应性的诊断优势比（16.0；95%CI 5-48）和汇总受试者工作特征曲线下面积（0.87；95%CI 0.78-0.95）非常好，但存在显著异质性。这可以用容积描记变异指数在自主呼吸或儿科患者以及使用除胶体液以外的前负荷挑战的研究中的准确性较低来解释。结果为未来的研究指明了具体方向。
