Taniguchi Leandro Utino, Zampieri Fernando Godinho, Nassar Antonio Paulo
Disciplina de Emergências Clínicas, Faculdade de Medicina, Universidade de São Paulo - São Paulo (SP), Brasil.
Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês - São Paulo (SP), Brasil.
Rev Bras Ter Intensiva. 2017 Jan-Mar;29(1):70-76. doi: 10.5935/0103-507X.20170011.
: The present systematic review searched for published data on the prevalence of required conditions for proper assessment in critically ill patients.
: The Medline, Scopus and Web of Science databases were searched to identify studies that evaluated the prevalence of validated conditions for the fluid responsiveness assessment using respiratory variations in the stroke volume or another surrogate in adult critically ill patients. The primary outcome was the suitability of the fluid responsiveness evaluation. The secondary objectives were the type and prevalence of pre-requisites evaluated to define the suitability.
: Five studies were included (14,804 patients). High clinical and statistical heterogeneity was observed (I2 = 98.6%), which prevented us from pooling the results into a meaningful summary conclusion. The most frequent limitation identified is the absence of invasive mechanical ventilation with a tidal volume ≥ 8mL/kg. The final suitability for the fluid responsiveness assessment was low (in four studies, it varied between 1.9 to 8.3%, in one study, it was 42.4%).
: Applicability of the dynamic indices of preload responsiveness requiring heart-lung interactions might be limited in daily practice.
本系统评价检索已发表的数据，以了解危重症患者进行恰当评估所需条件的患病率。
检索Medline、Scopus和Web of Science数据库，以识别评估使用每搏量呼吸变异或其他替代指标评估成年危重症患者液体反应性的有效条件患病率的研究。主要结局是液体反应性评估的适用性。次要目标是为定义适用性而评估的先决条件的类型和患病率。
纳入5项研究（14804例患者）。观察到高度的临床和统计学异质性（I² = 98.6%），这使我们无法将结果汇总成有意义的总结结论。确定的最常见限制是缺乏潮气量≥8mL/kg的有创机械通气。液体反应性评估的最终适用性较低（4项研究中，其在1.9%至8.3%之间变化，1项研究中为42.4%）。
需要心肺相互作用的前负荷反应性动态指标在日常实践中的适用性可能有限。
