Department of Critical Care Medicine, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China.
Medical Department, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China.
BMC Anesthesiol. 2023 Jan 14;23(1):25. doi: 10.1186/s12871-023-01976-7.
To observe if blood return, also defined as the blood infusion test (BIT) could predict fluid responsiveness in critically ill patients with acute circulatory failure and renal replacement therapy (RRT).
This was a single-center, prospective, diagnostic accuracy study. Before BIT, the passive leg raise test (PLRT) was performed to record the change of cardiac output (ΔCO) by pulse contour analysis, and ΔCO > = 10% was defined as the fluid responder. Meanwhile, the change in velocity time integral (ΔVTI) was recorded by ultrasound. Later, the ΔCO and ΔVTI during BIT were recorded 5-10 min after PLRT. The receiver-operating characteristic curves of ΔCO and ΔVTI of BIT were performed in predicting the fluid responder defined by PLRT.
A total of 43 patients with acute circulatory failure undergoing RRT were enrolled in the present study, and 25 patients (58.1%) were recognized as responders during PLRT. According to the receiver-operating characteristic curves, the cutoff value of ΔCO was 10% and ΔVTI was 9% during BIT with the area under curve of 0.96 and 0.94, respectively.
BIT in RRT could identify fluid responsiveness in critically ill patients with shock.
ChiCTR-DDD-17010534. Registered on 30/01/2017 (retrospective registration).
观察回血（也称为血液输注试验 [BIT]）是否可预测伴有肾脏替代治疗（RRT）的急性循环衰竭危重症患者的液体反应性。
这是一项单中心前瞻性诊断准确性研究。在进行 BIT 之前，先进行被动抬腿试验（PLRT），通过脉搏轮廓分析记录心输出量（ΔCO）的变化，ΔCO≥10%定义为液体反应者。同时，记录超声心动图下速度时间积分（ΔVTI）的变化。之后，在 PLRT 后 5-10 分钟记录 BIT 时的 ΔCO 和 ΔVTI。绘制 BIT 时 ΔCO 和 ΔVTI 的受试者工作特征曲线，以预测 PLRT 定义的液体反应者。
本研究共纳入 43 例接受 RRT 的急性循环衰竭患者，其中 25 例（58.1%）在 PLRT 时被认为是反应者。根据受试者工作特征曲线，ΔCO 的截断值为 10%，ΔVTI 的截断值为 9%，曲线下面积分别为 0.96 和 0.94。
RRT 中的 BIT 可识别休克危重症患者的液体反应性。
ChiCTR-DDD-17010534。注册于 2017 年 01 月 30 日（回顾性注册）。
