计算得出的血浆容量状态与舌下微循环血流及器官损伤的关系。

The Relation of Calculated Plasma Volume Status to Sublingual Microcirculatory Blood Flow and Organ Injury.

作者信息

Laou Eleni, Papagiannakis Nikolaos, Ntalarizou Nicoletta, Choratta Theodora, Angelopoulou Zacharoula, Annousis Konstantinos, Sakellakis Minas, Kyriakaki Aikaterini, Ragias Dimitrios, Michou Anastasia, Chalkias Athanasios

机构信息

Department of Anesthesiology, Agia Sophia Children's Hospital, 11527 Athens, Greece.

First Department of Neurology, Eginition University Hospital, Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece.

出版信息

J Pers Med. 2023 Jun 30;13(7):1085. doi: 10.3390/jpm13071085.

DOI:10.3390/jpm13071085

PMID:37511698

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10381119/

Abstract

BACKGROUND

The calculated plasma volume status (cPVS) was validated as a surrogate of intravascular filling. The aim of this study is to assess the cPVS in relation to sublingual perfusion and organ injury.

METHODS

Pre- and postoperative cPVS were obtained by determining the actual and ideal plasma volume levels in surgical patients. The sublingual microcirculation was assessed using SDF imaging, and we determined the De Backer score, the Consensus Proportion of Perfused Vessels (Consensus PPV), and the Consensus PPV (small). Our primary outcome was the assessment of the distribution of cPVS and its association with intraoperative sublingual microcirculation and postoperative complications.

RESULTS

The median pre- and postoperative cPVS were -7.25% (IQR -14.29--1.88) and -0.4% (IQR -5.43-6.06), respectively ( < 0.001). The mean intraoperative administered fluid volume was 2.5 ± 2.5 L (1.14 L h). No statistically significant correlation was observed between the pre- or postoperative cPVS and sublingual microcirculation variables. Higher preoperative (OR = 1.04, = 0.098) and postoperative cPVS (OR = 1.057, = 0.029) were associated with postoperative organ injury and complications (sepsis (30%), anemia (24%), respiratory failure (13%), acute kidney injury (6%), hypotension (6%), stroke (3%)).

CONCLUSIONS

The calculated PVS was associated with an increased risk of organ injury and complications in this cohort.

摘要

背景

计算得出的血浆容量状态（cPVS）已被验证可作为血管内充盈的替代指标。本研究旨在评估cPVS与舌下灌注及器官损伤的关系。

方法

通过测定手术患者的实际和理想血浆容量水平来获取术前和术后的cPVS。使用侧流暗视野成像评估舌下微循环，我们测定了德贝克尔评分、灌注血管的共识比例（共识PPV）和小血管的共识PPV。我们的主要结局是评估cPVS的分布及其与术中舌下微循环和术后并发症的关联。

结果

术前和术后cPVS的中位数分别为-7.25%（四分位间距-14.29%至-1.88%）和-0.4%（四分位间距-5.43%至6.06%）（<0.001）。术中平均补液量为2.5±2.5L（1.14L/h）。术前或术后cPVS与舌下微循环变量之间未观察到统计学上的显著相关性。术前较高的cPVS（比值比=⒈04，P=0.098）和术后cPVS（比值比=⒈057，P=0.029）与术后器官损伤和并发症相关（脓毒症（30%）、贫血（24%）、呼吸衰竭（13%）、急性肾损伤（6%）、低血压（6%）、中风（3%））。