Rodríguez Aparicio Edith Elianna, Almanza Hernández David Fernando, Rubio Ramos Cristhian, Moreno Knudsen María Paula, Rodriguez Lima David Rene
Critical and Intensive Care Medicine, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia.
Critical and Intensive Care Medicine, Hospital Universitario Mayor-Méderi, Bogotá, Colombia.
Ultrasound J. 2024 May 27;16(1):29. doi: 10.1186/s13089-024-00379-0.
Ultrasound measurement of the radial resistance index (RRI) in the anatomical snuffbox has been proposed as a useful method for assessing the systemic vascular resistance index (SVRI). This study aims to establish the correlation between SVRI measured by pulmonary artery catheter (PAC) and RRI.
A cross-sectional study included all consecutive patients undergoing postoperative (POP) cardiac surgery with hemodynamic monitoring using PAC. Hemodynamic assessment was performed using PAC, and RRI was measured with ultrasound in the anatomical snuffbox. The Pearson correlation test was used to establish the correlation between RRI and SVRI measured using PAC. Hemodynamic behavior concerning RRI with a cutoff point of 1.1 (described to estimate under SVRI) was examined. Additionally, consistency between two evaluators was assessed for RRI using the intraclass correlation coefficient and Bland-Altman analysis.
A total of 35 measurements were obtained. The average cardiac index (CI) was 2.73 ± 0.64 L/min/m², and the average SVRI was 1967.47 ± 478.33 dyn·s·m²/cm. The correlation between RRI and SVRI measured using PAC was 0.37 [95% CI 0.045-0.62]. The average RRI was 0.94 ± 0.11. RRI measurements > 1.1 had a mean SVRI of 2120.79 ± 673.48 dyn·s·m²/cm, while RRI measurements ≤ 1.1 had a mean SVRI of 1953.1 ± 468.17 dyn·s·m²/cm (p = 0.62). The consistency between evaluators showed an intraclass correlation coefficient of 0.88 [95% CI 0.78-0.93], and Bland-Altman analysis illustrated adequate agreement of RRI evaluators.
For patients in cardiac surgery POP, the correlation between the SVRI measured using PAC and the RRI measured in the anatomical snuffbox is low. Using the RRI as a SVRI estimator for patients is not recommended in this clinical scenario.
有人提出，通过超声测量解剖学鼻烟壶处的桡动脉阻力指数（RRI）是评估全身血管阻力指数（SVRI）的一种有用方法。本研究旨在确定通过肺动脉导管（PAC）测量的SVRI与RRI之间的相关性。
一项横断面研究纳入了所有接受心脏手术后（POP）并使用PAC进行血流动力学监测的连续患者。使用PAC进行血流动力学评估，并在解剖学鼻烟壶处用超声测量RRI。采用Pearson相关性检验来确定RRI与使用PAC测量的SVRI之间的相关性。研究了RRI截止值为1.1（用于估计低于SVRI的情况）时的血流动力学行为。此外，使用组内相关系数和Bland-Altman分析评估了两位评估者对RRI评估的一致性。
共获得35次测量数据。平均心脏指数（CI）为2.73±0.64L/min/m²，平均SVRI为1967.47±478.33dyn·s·m²/cm。使用PAC测量的RRI与SVRI之间的相关性为0.37[95%CI 0.045-0.62]。平均RRI为0.94±0.11。RRI测量值>1.1时，平均SVRI为2120.79±673.48dyn·s·m²/cm，而RRI测量值≤1.1时，平均SVRI为1953.1±468.17dyn·s·m²/cm（p=0.62）。评估者之间的一致性显示组内相关系数为0.88[95%CI 0.78-0.93]，Bland-Altman分析表明RRI评估者之间具有充分的一致性。
对于心脏手术后POP患者，使用PAC测量的SVRI与在解剖学鼻烟壶处测量的RRI之间的相关性较低。在这种临床情况下，不建议将RRI用作患者的SVRI估计值。
