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评估大手术后血管内液体状态的颈总动脉直径与中心静脉压之间的关系:一项观察性研究。

The Relation Between Common Carotid Artery Diameter and Central Venous Pressure for Assessment of Intravascular Fluid Status after Major Surgeries; an Observational Study.

作者信息

Kasem Rashwan Samaa A, Bassiouny Ashraf Abd Elmawgood, Badawy Ahmed A, Mohammed Ahmed Rabea

机构信息

Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.

Faculty of Medicine-Cairo University, Cairo, Egypt.

出版信息

Anesth Pain Med. 2020 Aug 12;10(4):e105138. doi: 10.5812/aapm.105138. eCollection 2020 Aug.

Abstract

OBJECTIVES

The current study aimed to find the relation between the changes in the common carotid artery (CCA) diameter and the central venous pressure (CVP) in response to a fluid challenge in spontaneously breathing adult patients.

METHODS

This study included 65 adult patients aged 20 - 60 years who were admitted to the surgical ICU. The CCA diameter and CVP were measured before and after fluid challenge, and the percentage of increase in the CCA diameter and CVP were calculated. The correlation was assessed between changes in the CVP and CCA diameter.

RESULTS

The CCA diameter before fluid administration had a significant strong positive correlation to the CVP (r = 0.8, P value < 0.001); the increase in the CCA diameter after fluid administration had a significant moderate positive correlation with the increase in the CVP (r = 0.4, P value < 0.001). The percentage of increase in CCA diameters was positively correlated to the percentage of increase in CVP (r = 0.589, P value = 0.001) following fluid administration. However, the Receiver Operating Characteristic (ROC) analysis was an invalid test (area under curve 0.513, P value = 0.885).

CONCLUSIONS

After major surgeries, the change in the CCA diameter was positively correlated with the change in the CVP values in response to fluid administration in the spontaneously breathing adult patients, but the cut-off limit cannot be reached.

摘要

目的

本研究旨在探寻自主呼吸的成年患者在接受液体冲击时,颈总动脉(CCA)直径变化与中心静脉压(CVP)之间的关系。

方法

本研究纳入了65名年龄在20至60岁之间入住外科重症监护病房的成年患者。在液体冲击前后测量CCA直径和CVP,并计算CCA直径和CVP的增加百分比。评估CVP变化与CCA直径变化之间的相关性。

结果

液体输注前CCA直径与CVP呈显著强正相关(r = 0.8,P值<0.001);液体输注后CCA直径的增加与CVP的增加呈显著中度正相关(r = 0.4,P值<0.001)。液体输注后,CCA直径增加百分比与CVP增加百分比呈正相关(r = 0.589,P值 = 0.001)。然而,受试者工作特征(ROC)分析是无效检验(曲线下面积0.513,P值 = 0.885)。

结论

在大手术后,自主呼吸的成年患者在接受液体输注时,CCA直径变化与CVP值变化呈正相关,但无法达到截断值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b2a/7539051/c85bd6601ce6/aapm-10-4-105138-i001.jpg

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