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基于超声的心输出量监测是定义高海拔地区健康常住居民基线血流动力学参数的有用工具:一项单中心初步研究的结果

The ultrasound-based cardiac output monitoring is a useful tool to define baseline hemodynamic parameters in healthy permanent residents at high altitude: results of a monocentric pilot study.

作者信息

Viruez-Soto Antonio, Molano-Franco Daniel, Merino-Luna Alfredo, Bairam Aida, Aliaga-Raduán Fernanda, Sanchez Lida, Arias-Reyes Christian, Soliz Jorge

机构信息

High Altitude Intensive Care Medicine International Group, GIMIA, La Paz, Bolivia.

High Altitude Intensive Care Medicine International Group, GIMIA, Bogota, Colombia.

出版信息

Front Physiol. 2024 Jan 17;14:1297872. doi: 10.3389/fphys.2023.1297872. eCollection 2023.

Abstract

Previous studies on the cardiac data of healthy permanent residents living in high-altitude regions such as Tibet and the Andes have yielded inconsistent findings and significant disparities. These discrepancies can be mainly attributed to the invasive methods conventionally used for parameter evaluation. However, with the introduction of cutting-edge ultrasound technology, there is now an innovative approach to addressing and reconciling these variations. In this pilot study, we employed an ultrasound-based cardiac output monitoring (USCOM) device to evaluate cardiac output and related hemodynamic variables in a group of 20 healthy high-altitude Andean residents (comprising 10 men and 10 women) aged between 26 and 35 years old. The monocentric study was carried out in La Paz, Bolivia, located between at an altitude of 3,600-4,000 m. A total of 60 hemodynamic measurements were evaluated, accounting for three technical replicates per subject. Our results showed strong intrasubject reproducibility and revealed important differences related to both sex and hemodynamic parameters in highlanders compared to individuals residing at sea level. We conclude that USCOM represents a highly reliable technology for performing hemodynamic measurements in high-altitude residents. Our preliminary findings underscore the need for larger studies, encompassing larger sample sizes, specifically tailored to gender considerations, and extendable to broader highland populations. These findings have special significant implications for the management of hemodynamics in intensive care and postoperative settings, warranting further comprehensive research efforts.

摘要

此前针对居住在西藏和安第斯山脉等高海拔地区的健康常住人口心脏数据的研究结果并不一致,存在显著差异。这些差异主要归因于传统上用于参数评估的侵入性方法。然而,随着前沿超声技术的引入,现在有一种创新方法来解决和协调这些差异。在这项试点研究中,我们使用基于超声的心输出量监测(USCOM)设备,对一组20名年龄在26至35岁之间的健康安第斯高海拔居民(包括10名男性和10名女性)的心输出量及相关血流动力学变量进行评估。这项单中心研究在玻利维亚拉巴斯进行,该地海拔在3600 - 4000米之间。总共评估了60次血流动力学测量,每位受试者进行三次技术重复测量。我们的结果显示出很强的受试者内重复性,并揭示了与海平面居民相比,高原居民在性别和血流动力学参数方面存在重要差异。我们得出结论,USCOM是一种在高海拔居民中进行血流动力学测量的高度可靠技术。我们的初步研究结果强调需要开展更大规模的研究,纳入更大的样本量,特别考虑性别因素,并扩展到更广泛的高原人群。这些发现对重症监护和术后环境中的血流动力学管理具有特殊重要意义,值得进一步开展全面的研究工作。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b782/10829573/b7062ebfc1f4/fphys-14-1297872-g001.jpg

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