超声测量下腔静脉直径对预测癌症患者血管内液体输注反应性的实用性。

Usefulness of ultrasonographic measurement of the diameter of the inferior vena cava to predict responsiveness to intravascular fluid administration in patients with cancer.

作者信息

Ñamendys-Silva Silvio A, Arredondo-Armenta Juan M, Guevara-García Humberto, Barragán-Dessavre Mireya, García-Guillén Francisco J, Sánchez-Hurtado Luis A, Córdova-Sánchez Bertha, Bautista-Ocampo Andoreni R, Herrera-Gómez Angel, Meneses-García Abelardo

机构信息

Department of Critical Care Medicine, Instituto Nacional de Cancerología, México (Ñamendys-Silva, Arredondo-Armenta, Guevara-García, Barragán-Dessavre, García-Guillén, Sánchez-Hurtado, Córdova-Sánchez, Bautista-Ocampo, Herrera-Gómez, Meneses-García); Department of Critical Care Medicine, Fundación Clínica Médica Sur, Ciudad de México (Ñamendys-Silva, Arredondo-Armenta, Barragán-Dessavre); and Department of Critical Care Medicine, Hospital de Especialidades Centro Médico Nacional La Raza, Mexican Institute of Social Security, Mexico City, Mexico (Sánchez-Hurtado).

出版信息

Proc (Bayl Univ Med Cent). 2016 Oct;29(4):374-377. doi: 10.1080/08998280.2016.11929474.

DOI:10.1080/08998280.2016.11929474

PMID:27695165

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5023287/

Abstract

We conducted an observational, longitudinal prospective study in which we measured the diameters of the inferior vena cava (IVC) of 47 patients using ultrasonography. The aim of our study was to assess the state of blood volume and to determine the percentage of patients who responded to intravascular volume expansion. Only 17 patients (36%) responded to fluid management. A higher number of responding patients had cardiovascular failure compared with nonresponders (82% vs. 50%, = 0.03). Among the patients with cardiovascular failure, the probability of finding responders was 4.6 times higher than that of not finding responders (odds ratio, 4.66; 95% confidence interval, 1.10-19.6; = 0.04). No significant difference was observed in the mortality rate between the two groups (11% vs. 23%, = 0.46). In conclusion, responding to intravascular volume expansion had no impact on patient survival in the intensive care unit.

摘要

我们进行了一项观察性纵向前瞻性研究，在此研究中，我们使用超声测量了47例患者的下腔静脉（IVC）直径。我们研究的目的是评估血容量状态，并确定对血管内容量扩充有反应的患者百分比。只有17例患者（36%）对液体管理有反应。与无反应者相比，有反应的患者中患有心血管衰竭的人数更多（82%对50%，P = 0.03）。在患有心血管衰竭的患者中，发现有反应者的概率比未发现有反应者的概率高4.6倍（优势比，4.66；95%置信区间，1.10 - 19.6；P = 0.04）。两组之间的死亡率未观察到显著差异（11%对23%，P = 0.46）。总之，对血管内容量扩充有反应对重症监护病房患者的生存没有影响。