Bilgili Beliz, Haliloglu Murat, Tugtepe Halil, Umuroglu Tumay
a Marmara University, School of Medicine , Department of Anesthesiology and Reanimation , Pendik, Istanbul , Turkey.
b Marmara University, School of Medicine , Department of Pediatric Surgery , Pendik, Istanbul , Turkey.
J Invest Surg. 2018 Dec;31(6):523-528. doi: 10.1080/08941939.2017.1364806. Epub 2017 Sep 27.
The purpose of this work is to assess the predictive value, for fluid responsiveness (FR), of the inferior vena cava distensibility index (IVC-DI) and internal jugular vein distensibility index (IJV-DI) in pediatric surgical patients.
Prior to being placed under general anesthesia, 24 surgical patients were enrolled. Baseline parameters were recorded with the patient in the semirecumbent position (Stage 1). Next, the passive leg raising (PLR) maneuver was carried out and a second measurement was recorded (Stage 2). Patients with an increase in the cardiac index (CI) of >10%, induced by PLR, were considered to be responders (R), otherwise they were classified as nonresponders (NR). At both stages, CI and DI of the IVC and IJV were measured.
Responders had higher IVC-DI and IVJ-DI than NR in stage 1 (both p <.001). In stage 2, IVC-DI and IJV-DI were not different in R and NR groups (p =.164, p =.201). Utilizing cut-off values of > 22.7% for IVC-DI and > 25% for IJV-DI, these parameters had positive correlation coefficients, both in R and NR of, respectively, 0.626 and 0.929.
The IVC-DI predicts FR in anesthetized pediatric patients and correlates well with the IJV-DI; both may be used as prediction markers of FR in children.
本研究旨在评估小儿外科手术患者下腔静脉扩张指数（IVC-DI）和颈内静脉扩张指数（IJV-DI）对液体反应性（FR）的预测价值。
纳入24例手术患者，在全身麻醉前进行研究。患者处于半卧位时记录基线参数（阶段1）。接下来，进行被动抬腿（PLR）操作，并记录第二次测量结果（阶段2）。PLR诱导心脏指数（CI）增加>10%的患者被视为反应者（R），否则分类为无反应者（NR）。在两个阶段均测量IVC和IJV的CI和DI。
在阶段1，反应者的IVC-DI和IVJ-DI高于无反应者（均p<.001）。在阶段2，R组和NR组的IVC-DI和IJV-DI无差异（p = 0.164，p = 0.201）。使用IVC-DI>22.7%和IJV-DI>25%的截断值，这些参数在R组和NR组中的相关系数分别为0.626和0.929。
IVC-DI可预测麻醉小儿患者的FR，且与IJV-DI相关性良好；两者均可作为儿童FR的预测指标。
