Division of Pediatric Critical Care Medicine, Pediatric Sepsis Study Group, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Kweishan, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
College of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
J Crit Care. 2019 Feb;49:45-49. doi: 10.1016/j.jcrc.2018.10.010. Epub 2018 Oct 16.
To compare systemic vascular resistance index (SVRI) as measured by invasive transpulmonary indicator dilution (TPID) and non-invasive Doppler-derived resistive index in septic patients.
We measured the snuffbox resistive index (SBRI) in both hands of septic patients who received hemodynamic monitoring by TPID prospectively.
Thirty-six patients with septic shock were enrolled (median acute physiology and chronic health evaluation II score: 23; median age: 64 years). Four SBRI values were measured in each patient, for a total of 96 patient days and 951 ultrasound measurements. The correlation coefficients between SVRI and the four SBRI values were all higher than 0.87 (p < .001). A higher SVRI was associated with sharp waveforms and reversed diastolic flow. A resistive index (RI) of 0.97 was the lower limit of normal SVRI (1700 dynscmm), and an RI of 1.1 was the upper limit of normal SVRI (2400 dynscmm).
Using ultrasound to measure RI is a noninvasive, inexpensive, reliable method to evaluate peripheral vascular resistance in septic patients, and it is highly correlated with SVRI. In addition, SBRI can be used to evaluate peripheral circulatory disturbances in septic patients.
比较经肺指示剂稀释法（TPID）测量的系统性血管阻力指数（SVRI）与感染性休克患者无创性多普勒衍生阻力指数的差异。
前瞻性地对接受 TPID 血流动力学监测的感染性休克患者测量双手的鼻咽阻力指数（SBRI）。
共纳入 36 例感染性休克患者（急性生理学与慢性健康状况评分Ⅱ中位数：23；中位年龄：64 岁）。每位患者测量 4 次 SBRI 值，共计 96 个患者日和 951 次超声测量。SVRI 与 4 个 SBRI 值之间的相关系数均高于 0.87（p<.001）。较高的 SVRI 与尖锐的血流波形和反向舒张期血流相关。RI 为 0.97 是正常 SVRI（1700 dynscmm）的下限，RI 为 1.1 是正常 SVRI（2400 dynscmm）的上限。
使用超声测量 RI 是一种非侵入性、廉价、可靠的方法，可用于评估感染性休克患者的外周血管阻力，与 SVRI 高度相关。此外，SBRI 可用于评估感染性休克患者的外周循环障碍。
