液体冲击试验对视神经鞘直径的影响。

The Effect of Fluid Challenge Test on Optic Nerve Sheath Diameter.

机构信息

Department of Anesthesiology and Reanimation, Ondokuz Mayis University, Faculty of Medicine, Samsun, Turkey.

出版信息

J Coll Physicians Surg Pak. 2022 Sep;32(9):1116-1121. doi: 10.29271/jcpsp.2022.09.1116.

DOI:10.29271/jcpsp.2022.09.1116

PMID:36089705

Abstract

OBJECTIVE

To investigate the effect of the fluid challenge test on the optic nerve sheath diameter (ONSD) change.

STUDY DESIGN

Quasi-experimental study.

PLACE AND DURATION OF STUDY

Department of Anesthesiology and Reanimation, Ondokuz Mayis University Hospital, Samsun, Turkey, from January to November 2021.

METHODOLOGY

A fluid challenge was defined as a 500 mL crystalloid infusion administered over 10 minutes, and fluid responsiveness was defined as a subsequent increase in stroke volume of at least 15% administered to the ICU patients. The ONSD and hemodynamic variables were measured by ultrasonography before (T0), at the end (T1), and 30 min after the fluid challenge (T2). The primary outcome of the study was the change in ONSD measurements associated with the fluid challenge, and the secondary outcome was the relationship between fluid responsiveness and the change in ONSD.

RESULTS

A total of 60 patients were included. The ONSD (mm) value was significantly higher at T1 compared to T0 (mean ± standard deviation: 5.12±0.30 mm vs. 5.10±0.32 mm; p=0.011). However, at T2, the ONSD was similar to that at T0 (5.10±0.31 mm vs. 5.10±0.32 mm; p=0.662). The stroke volume (mL) was also significantly higher at T1 and T2 compared to T0 [median IQR 60 (6) mL vs. 60 (4.7) mL vs. 52 (5) mL, respectively, p <0.01]. No significant relationship was found between the ONSD and the change in fluid responsiveness (p=0.621).

CONCLUSION

The fluid challenge test increases ONSD and may cause an increase in intracranial pressure.

KEY WORDS

Fluid therapy, Stroke volume, Intracranial pressure, Ultrasonography, Optic nerve sheath diameter.

摘要

目的

研究液体冲击试验对视神经鞘直径（ONSD）变化的影响。

研究设计

准实验研究。

地点和研究时间

土耳其翁多卢梅希斯大学医院麻醉与复苏科，2021 年 1 月至 11 月。

方法

将 500 毫升晶体液输注 10 分钟定义为液体冲击，将 ICU 患者接受至少 15%的血容量增加定义为液体反应性。在冲击前（T0）、冲击结束时（T1）和冲击后 30 分钟（T2）通过超声测量 ONSD 和血流动力学变量。研究的主要结果是与液体冲击相关的 ONSD 测量变化，次要结果是液体反应性与 ONSD 变化之间的关系。

结果

共纳入 60 例患者。与 T0 相比，T1 时 ONSD（mm）值明显升高（均值±标准差：5.12±0.30mm 比 5.10±0.32mm；p=0.011）。然而，在 T2 时，ONSD 与 T0 时相似（5.10±0.31mm 比 5.10±0.32mm；p=0.662）。T1 和 T2 时的每搏量（mL）也明显高于 T0 [中位数（IQR）分别为 60（6）mL 比 60（4.7）mL 比 52（5）mL，均 p<0.01]。ONSD 与液体反应性变化之间无显著相关性（p=0.621）。