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低血压预测指数联合脑氧合在指导术中血流动力学管理中的应用:一例病例报告

Hypotension prediction index together with cerebral oxygenation in guiding intraoperative hemodynamic management: a case report.

作者信息

Li Yun, Phan Janet, Mamoor Azaam, Liu Hong

机构信息

Department of Anesthesiology, the Second Hospital of Anhui Medical University, Hefei, Anhui 230601, China.

Department of Anesthesiology and Pain Medicine, University of California Davis Health, Sacramento, CA 95817, USA.

出版信息

J Biomed Res. 2022 Jan 10;36(1):63-67. doi: 10.7555/JBR.36.20210164.

Abstract

Intraoperative hypotension happens in everyday clinical practice. It was suggested to have a strong association with adverse postoperative outcomes. Hypotension prediction index (HPI) was developed to predict intraoperative hypotension (mean arterial pressure <65 mmHg) in real time. However, pressure autoregulation also plays an important role in maintaining adequate organ perfusion/oxygenation during hypotension. A cerebral oxygenation monitor provides clinicians with the values of organ oxygenation. We reported a case that the cerebral oxygenation monitor was used together with HPI to guide intraoperative blood pressure management. We found that cerebral oxygenation was maintained in the event of hypotension during surgery. The patient had no intraoperative or postoperative adverse outcomes despite the hypotension. We believe this can provide an individualized intraoperative blood pressure management to avoid over- or under-treating hypotension.

摘要

术中低血压在日常临床实践中时有发生。研究表明,其与术后不良结局密切相关。低血压预测指数(HPI)旨在实时预测术中低血压(平均动脉压<65 mmHg)。然而,压力自动调节在低血压期间维持充足的器官灌注/氧合方面也起着重要作用。脑氧监测仪可为临床医生提供器官氧合值。我们报告了一例将脑氧监测仪与HPI联合用于指导术中血压管理的病例。我们发现,手术过程中即使出现低血压,脑氧合仍能维持。尽管发生了低血压,但该患者未出现术中或术后不良结局。我们认为,这可为个体化的术中血压管理提供参考,以避免低血压治疗过度或不足。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8b9/8894284/1305a328e7fe/jbr-36-1-63-1.jpg

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