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无创参数(下腔静脉直径、下腔静脉可压缩性、下腔静脉与主动脉比值)在危重症儿童血流动力学监测中的应用:一项系统评价

Usefulness of Non-Invasive Parameters (Inferior Vena Cava Diameter, Inferior Vena Cava Collapsibility, Inferior Vena Cava-Aortic Ratio) for Hemodynamic Monitoring in Critically Ill Children: A Systematic Review.

作者信息

Hakim Dzulfikar Djalil Lukman, Meilyana Fina, Peryoga Stanza Uga, Arniawati Irma, Wijaya Elrika Anastasia, Martiano Muhamad Rinaldhi

机构信息

Department of Child Health, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia.

出版信息

Med Devices (Auckl). 2024 Mar 18;17:123-133. doi: 10.2147/MDER.S454849. eCollection 2024.

Abstract

PURPOSE

Volume measurement in critically ill children can be conducted using invasive procedure such as Central Venous Pressure (CVP), or non-invasive procedure such as measurement of Inferior Vena Cava (IVC) indices using ultrasonography. However, their accuracy and efficacy are still under scrutiny. We aim to compare CVP and IVC indices as non-invasive parameters in assessing volume status in critically ill children.

METHODS

We conducted a systematic review based on literature searching from four electronic databases which were PubMed, Cochrane, ScienceDirect, SpringerLink with keywords: "CENTRAL VENOUS PRESSURE", "INFERIOR VENA CAVA DIAMETER", "INFERIOR VENA CAVA COLLAPSIBILITY", "INFERIOR VENA CAVA AORTIC-RATIO", "VOLUME STATUS", "FLUID STATUS", "CRITICAL ILL", "CHILDREN", and "PEDIATRICS". We included relevant studies in English published from 2000 to 2023 on critically ill children aged 0-18 years. Comparison between CVP and IVC indices was resumed.

RESULTS

Eight articles were included in this study. Majority of the studies showed a consistent correlation between CVP and IVC indices. IVC-CI was the most common parameter evaluated in the included studies. There was moderate to strong correlations using IVC-CI and IVC-DI, and moderate correlation using IVC-Ao ratio.

CONCLUSION

We found that non-invasive tools might have a potential role to measure volume in critically ill children equals to CVP. Further high-quality and longitudinal studies are needed to validate these findings and to establish a clear guideline for the non-invasive tool to be used in daily clinical practice.

摘要

目的

对于危重症儿童的容量评估,可以采用侵入性操作,如中心静脉压(CVP)测量,也可以采用非侵入性操作,如使用超声测量下腔静脉(IVC)指标。然而,它们的准确性和有效性仍在研究中。我们旨在比较CVP和IVC指标作为评估危重症儿童容量状态的非侵入性参数。

方法

我们基于对四个电子数据库(PubMed、Cochrane、ScienceDirect、SpringerLink)的文献检索进行了系统评价,关键词为:“中心静脉压”、“下腔静脉直径”、“下腔静脉可塌陷性”、“下腔静脉与主动脉比值”、“容量状态”、“液体状态”、“危重症”、“儿童”和“儿科学”。我们纳入了2000年至2023年发表的关于0至18岁危重症儿童的英文相关研究。恢复了CVP和IVC指标之间的比较。

结果

本研究纳入了八篇文章。大多数研究表明CVP和IVC指标之间存在一致的相关性。IVC-CI是纳入研究中评估最常见的参数。使用IVC-CI和IVC-DI时有中度至强相关性,使用IVC-Ao比值时有中度相关性。

结论

我们发现非侵入性工具在测量危重症儿童容量方面可能具有与CVP相当的潜在作用。需要进一步的高质量纵向研究来验证这些发现,并为日常临床实践中使用的非侵入性工具建立明确的指南。

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