Liu Chunyu, An Ran, Liu Hongliang
Department of Anesthesiology, Chongqing University Cancer Hospital, Chongqing 400030, China.
J Pers Med. 2024 Apr 25;14(5):452. doi: 10.3390/jpm14050452.
Postinduction hypotension (PIH) is closely associated with postoperative adverse outcomes. Preoperative hypovolemia is a key risk factor, and many parameters are available from ultrasound to detect hypovolemia, but the accuracy of PIH from ultrasound remains unclear. This systematic review and meta-analysis aimed to evaluate the commonly used measurements from ultrasound to predict PIH. We searched the PubMed, Cochrane Library, Embase, CNKI, and Web of Science databases from their inception to December 2023. Thirty-six studies were included for quantitative analysis. The pooled sensitivities for the inferior vena cava collapsibility index (IVC-CI), maximum inferior vena cava diameter (DIVCmax), minimum inferior vena cava diameter (DIVCmin), and carotid artery corrected flow time (FTc) were 0.73 (95% CI = 0.65, 0.79), 0.66 (95% CI = 0.54, 0.77), 0.74 (95% CI = 0.60, 0.85), and 0.81 (95% CI = 0.72, 0.88). The pooled specificities for the IVC-CI, DIVCmax, DIVCmin, and carotid artery FTc were 0.82 (95% CI = 0.75, 0.87), 0.75 (95% CI = 0.66, 0.82), 0.76 (95% CI = 0.65, 0.84), and 0.87 (95% CI = 0.77, 0.93). The AUC for the IVC-CI, DIVCmax, DIVCmin, and carotid artery FTc were 0.84 (95% CI = 0.81, 0.87), 0.77 (95% CI = 0.73, 0.81), 0.82 (95% CI = 0.78, 0.85), and 0.91 (95% CI = 0.88, 0.93). Our study demonstrated that ultrasound indices are reliable predictors for PIH. The carotid artery FTc is probably the optimal ultrasound measurement for identifying patients who will develop PIH in our study.
诱导后低血压（PIH）与术后不良结局密切相关。术前血容量不足是一个关键危险因素，超声可提供许多参数来检测血容量不足，但超声预测PIH的准确性仍不清楚。本系统评价和荟萃分析旨在评估超声常用测量方法对PIH的预测价值。我们检索了PubMed、Cochrane图书馆、Embase、中国知网和Web of Science数据库，检索时间从建库至2023年12月。纳入36项研究进行定量分析。下腔静脉塌陷指数（IVC-CI）、下腔静脉最大直径（DIVCmax）、下腔静脉最小直径（DIVCmin）和颈动脉校正血流时间（FTc）的合并敏感度分别为0.73（95%CI=0.65，0.79）、0.66（95%CI=0.54，0.77）、0.74（95%CI=0.60，0.85）和0.81（95%CI=0.72，0.88）。IVC-CI、DIVCmax、DIVCmin和颈动脉FTc的合并特异度分别为0.82（95%CI=0.75，0.87）、0.75（95%CI=0.66，0.82）、0.76（95%CI=0.65，0.84）和0.87（95%CI=0.77，0.93）。IVC-CI、DIVCmax、DIVCmin和颈动脉FTc的AUC分别为0.84（95%CI=0.81，0.87）、0.77（95%CI=0.73，0.81）、0.82（95%CI=0.78，0.85）和0.91（95%CI=0.88，0.93）。我们的研究表明，超声指标是PIH的可靠预测指标。在我们的研究中，颈动脉FTc可能是识别将发生PIH患者的最佳超声测量指标。
