外周静脉容量分析（PIVA）用于定量评估急性失代偿性心力衰竭住院患者的容量超负荷：一项初步研究。
Peripheral Intravenous Volume Analysis (PIVA) for Quantitating Volume Overload in Patients Hospitalized With Acute Decompensated Heart Failure-A Pilot Study.
机构信息
Vanderbilt University Medical Center, Department of Anesthesiology, Division of Critical Care, Nashville, Tennessee.
Vanderbilt University Medical Center, Department of Anesthesiology, Division of Critical Care, Nashville, Tennessee.
出版信息
J Card Fail. 2018 Aug;24(8):525-532. doi: 10.1016/j.cardfail.2018.05.003. Epub 2018 May 16.
BACKGROUND
To determine the feasibility of peripheral intravenous volume analysis (PIVA) of venous waveforms for assessing volume overload in patients admitted to the hospital with acute decompensated heart failure (ADHF).
METHODS
Venous waveforms were captured from a peripheral intravenous catheter in subjects admitted for ADHF and healthy age-matched controls. Admission PIVA signal, brain natriuretic peptide, and chest radiographic measurements were related to the net volume removed during diuresis.
RESULTS
ADHF patients had a significantly greater PIVA signal on admission compared with the control group (P = .0013, n = 18). At discharge, ADHF patients had a PIVA signal similar to the control group. PIVA signal, not brain natriuretic peptide or chest radiographic measures, accurately predicted the amount of volume removed during diuresis (R = 0.781, n = 14). PIVA signal at time of discharge greater than 0.20, demonstrated 83.3% 120-day readmission rate.
CONCLUSIONS
This study demonstrates the feasibility of PIVA for assessment of volume overload in patients admitted to the hospital with ADHF.
背景
为了确定外周静脉容量分析（PIVA）静脉波形用于评估因急性失代偿性心力衰竭（ADHF）入院患者容量超负荷的可行性。
方法
从因 ADHF 入院的患者和年龄匹配的健康对照组的外周静脉导管中采集静脉波形。入院时的 PIVA 信号、脑利钠肽和胸部 X 线测量值与利尿过程中去除的净容量相关。
结果
与对照组相比，ADHF 患者入院时的 PIVA 信号明显更高（P =.0013，n = 18）。出院时，ADHF 患者的 PIVA 信号与对照组相似。PIVA 信号而不是脑利钠肽或胸部 X 线测量值准确预测了利尿过程中去除的容量（R = 0.781，n = 14）。出院时的 PIVA 信号大于 0.20，显示 120 天再入院率为 83.3%。
结论
本研究表明 PIVA 可用于评估因 ADHF 入院患者的容量超负荷。
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