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液体负荷试验期间中心静脉压的变化对指导液体治疗的价值有限。

Changes in central venous pressure during a fluid challenge have limited value for guiding fluid therapy.

作者信息

de Oliveira Priscilla Souza, Ramos Fernando José da Silva, Tomotani Daniere Yurie Vieira, Machado Flávia Ribeiro, de Freitas Flávio Geraldo Rezende

机构信息

Department of Anesthesiology, Pain and Intensive Care Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo - São Paulo (SP), Brazil.

出版信息

Crit Care Sci. 2024 Dec 2;36:e20240073en. doi: 10.62675/2965-2774.20240073-en. eCollection 2024.

DOI:10.62675/2965-2774.20240073-en
PMID:39630827
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11634234/
Abstract

OBJECTIVE

To evaluate whether changes in central venous pressure during fluid expansion and baseline cyclic respiratory variation in the central venous pressure amplitude (RespCVP) curve could be used to discriminate between fluid responders and nonresponders.

METHODS

This prospective observational study included critically ill adult patients who underwent fluid expansion in the form of a fluid bolus or fluid challenge with crystalloids. All patients were under mechanical ventilation and adequately sedated. We determined the central venous pressure at baseline (CVPT0) and the changes at 5 (ΔCVPT5), 10 (ΔCVPT10) and 15 (ΔCVPT15) minutes during fluid infusion. We also measured the RespCVP at baseline. Fluid responsiveness was defined as a cardiac index increase of ≥ 15%.

RESULTS

The study included 30 patients (11 responders and 19 nonresponders). The CVPT0 and the changes after a fluid challenge at all three time points did not adequately predict fluid responsiveness, as determined by their area under the curve values (CVPT0: 0.70, (95%CI: 0.49 - 0.90; ΔCVPT5: 0.78, (95%CI: 0.57 - 0.99; ΔCVPT10: 0.63, (95%CI: 0.39 - 0.88; ΔCVPT15: 0.68, ((95%CI: 0.45 - 0.92). The RespCVP at baseline also had a poor performance (area under the curve: 0.70; 95%CI: 0.50 - 0.91).

CONCLUSION

Changes in central venous pressure have limited value in predicting fluid responsiveness.

摘要

目的

评估液体扩容期间中心静脉压的变化以及中心静脉压幅度（RespCVP）曲线的基线周期性呼吸变化是否可用于区分液体反应者和无反应者。

方法

这项前瞻性观察性研究纳入了接受晶体液推注或液体激发形式的液体扩容的成年危重症患者。所有患者均接受机械通气并充分镇静。我们测定了基线时的中心静脉压（CVPT0）以及液体输注期间5分钟（ΔCVPT5）、10分钟（ΔCVPT10）和15分钟（ΔCVPT15）时的变化。我们还测量了基线时的RespCVP。液体反应性定义为心脏指数增加≥15%。

结果

该研究纳入了30例患者（11例反应者和19例无反应者）。通过曲线下面积值确定，CVPT0以及所有三个时间点液体激发后的变化均不能充分预测液体反应性（CVPT0：0.70，（95%CI：0.49 - 0.90；ΔCVPT5：0.78，（95%CI：0.57 - 0.99；ΔCVPT10：0.63，（95%CI：0.39 - 0.88；ΔCVPT15：0.68，（95%CI：0.45 - 0.92）。基线时的RespCVP表现也不佳（曲线下面积：0.70；95%CI：0.50 - 0.91）。

结论

中心静脉压的变化在预测液体反应性方面价值有限。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c4c/11634234/0226a03671b2/2965-2774-ccsci-36-e20240073en-pt-gf02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c4c/11634234/0aab873a8f40/2965-2774-ccsci-36-e20240073en-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c4c/11634234/d578874ac666/2965-2774-ccsci-36-e20240073en-gf02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c4c/11634234/3cf221c85a09/2965-2774-ccsci-36-e20240073en-pt-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c4c/11634234/0226a03671b2/2965-2774-ccsci-36-e20240073en-pt-gf02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c4c/11634234/0aab873a8f40/2965-2774-ccsci-36-e20240073en-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c4c/11634234/d578874ac666/2965-2774-ccsci-36-e20240073en-gf02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c4c/11634234/3cf221c85a09/2965-2774-ccsci-36-e20240073en-pt-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c4c/11634234/0226a03671b2/2965-2774-ccsci-36-e20240073en-pt-gf02.jpg

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本文引用的文献

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Fluid Therapy for Critically Ill Adults With Sepsis: A Review.严重脓毒症成人的液体治疗：综述。
JAMA. 2023 Jun 13;329(22):1967-1980. doi: 10.1001/jama.2023.7560.
2
How I personalize fluid therapy in septic shock?如何在感染性休克中进行个体化液体治疗？
Crit Care. 2023 Mar 24;27(1):123. doi: 10.1186/s13054-023-04363-3.
3
Central venous pressure (CVP).中心静脉压（CVP）。
Intensive Care Med. 2022 Oct;48(10):1498-1500. doi: 10.1007/s00134-022-06835-6. Epub 2022 Aug 11.
4
How can assessing hemodynamics help to assess volume status?评估血流动力学如何帮助评估血容量状态？
Intensive Care Med. 2022 Oct;48(10):1482-1494. doi: 10.1007/s00134-022-06808-9. Epub 2022 Aug 10.
5
Prediction of fluid responsiveness. What's new?液体反应性的预测。有什么新进展？
Ann Intensive Care. 2022 May 28;12(1):46. doi: 10.1186/s13613-022-01022-8.
6
Resuscitation fluid practices in Brazilian intensive care units: a secondary analysis of Fluid-TRIPS.巴西重症监护病房的复苏液体应用：Fluid-TRIPS的二次分析
Rev Bras Ter Intensiva. 2021 Apr-Jun;33(2):206-218. doi: 10.5935/0103-507X.20210028.
7
Increase in Central Venous Pressure During Passive Leg Raising Cannot Detect Preload Unresponsiveness.被动抬腿时中心静脉压升高不能检测前负荷无反应。
Crit Care Med. 2020 Aug;48(8):e684-e689. doi: 10.1097/CCM.0000000000004414.
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