Vo Hien Van, Nguyen Quynh Van, Le Anh Ngoc, Bui Tri Thi
Department of Anesthesia, Le Huu Trac National Burn Hospital Hanoi, Vietnam.
Department of Anesthesia, Vietnam Military Medical University Hanoi, Vietnam.
Int J Burns Trauma. 2025 Feb 15;15(1):1-10. doi: 10.62347/JNWH4046. eCollection 2025.
To evaluate changes in hemodynamic parameters using the Ultrasound Cardiac Output Monitoring (USCOM) method during general anesthesia for burn wound excision and skin grafting surgery in patients with severe burns.
This prospective observational study included 40 severe burn patients, aged 18-60 years, treated at the Intensive Care Unit (ICU) of Le Huu Trac National Burn Hospital (Hanoi, Vietnam). All patients underwent burn wound excision and skin grafting between June 2023 and March 2024.
The average heart rate (HR) at the study time points ranged from 116.8 to 124.3 beats/min. The differences in HR at T, T, T, T, and T compared to T were statistically significant (P < 0.05). Mean arterial pressure (MAP) at the study time points ranged from 73.8 mmHg to 95.68 mmHg. The differences in MAP at T, T, T, T, and T compared to T were statistically significant (P < 0.05). Cardiac Output (CO) and Cardiac Index (CI) values at all study time points were within normal ranges (6-7.04 l/min and 3.66-4.33 l/min/m, respectively). CO and CI were highest at T (7.04 l/min; 4.33 l/min/m) and lowest at T (6 l/min; 3.66 l/min/m). The differences in CO and CI at T, T, T, T, and T compared to T were statistically significant (P < 0.05). Stroke Volume (SV) and Stroke Volume Index (SVI) values at all time points were within normal ranges (51.2-56.75 ml and 30.93-34.53 ml/m). The differences in SV and SVI at T, T, and T compared to T were statistically significant (P < 0.05). Systemic Vascular Resistance (SVR) and Systemic Vascular Resistance Index (SVRI) values at all time points were within normal ranges (1006.03-1240.45 d.s.cm and 1681.98-2060.4 d.s.cm.m). SVR and SVRI were highest at T (1240.45 d.s.cm and 2060.4 d.s.cm.m) and lowest at T (1006.03 d.s.cm and 1681.98 d.s.cm.m). The differences in SVR and SVRI at T compared to T were statistically significant (P < 0.05).
The study demonstrated that hemodynamic parameters, including CO, CI, SV, SVI, SVR, and SVRI, remained within normal ranges throughout the anesthesia process. However, heart rate and blood pressure tended to be elevated, reflecting the hemodynamic characteristics of burn patients. This underscores the importance of close monitoring and adaptive management during anesthesia and resuscitation to ensure hemodynamic stability tailored to the characteristics of severe burn patients.
采用超声心输出量监测（USCOM）方法评估重度烧伤患者在烧伤创面切除和植皮手术全身麻醉期间血流动力学参数的变化。
这项前瞻性观察性研究纳入了40例年龄在18 - 60岁之间、在越南河内勒胡特拉克国家烧伤医院重症监护病房（ICU）接受治疗的重度烧伤患者。所有患者于2023年6月至2024年3月期间接受烧伤创面切除和植皮手术。
研究时间点的平均心率（HR）在116.8至124.3次/分钟之间。与T相比，T、T、T、T和T时的心率差异具有统计学意义（P < 0.05）。研究时间点的平均动脉压（MAP）在73.8 mmHg至95.68 mmHg之间。与T相比，T、T、T、T和T时的MAP差异具有统计学意义（P < 0.05）。所有研究时间点的心输出量（CO）和心脏指数（CI）值均在正常范围内（分别为6 - 7.04升/分钟和3.66 - 4.33升/分钟/平方米）。CO和CI在T时最高（7.04升/分钟；4.33升/分钟/平方米），在T时最低（6升/分钟；3.66升/分钟/平方米）。与T相比，T、T、T、T和T时的CO和CI差异具有统计学意义（P < 0.05）。所有时间点的每搏输出量（SV）和每搏输出量指数（SVI）值均在正常范围内（51.2 - 56.75毫升和30.93 - 34.53毫升/平方米）。与T相比，T、T和T时的SV和SVI差异具有统计学意义（P < 0.05）。所有时间点的全身血管阻力（SVR）和全身血管阻力指数（SVRI）值均在正常范围内（分别为1006.03 - 1240.45达因·秒/厘米和1681.98 - 2060.4达因·秒/厘米·平方米）。SVR和SVRI在T时最高（1240.45达因·秒/厘米和2060.4达因·秒/厘米·平方米），在T时最低（1006.03达因·秒/厘米和1681.98达因·秒/厘米·平方米）。与T相比，T时的SVR和SVRI差异具有统计学意义（P < 0.05）。
该研究表明，包括CO、CI、SV、SVI、SVR和SVRI在内的血流动力学参数在整个麻醉过程中均保持在正常范围内。然而，心率和血压往往会升高，反映了烧伤患者的血流动力学特征。这强调了在麻醉和复苏过程中密切监测和适应性管理的重要性，以确保根据重度烧伤患者的特征实现血流动力学稳定。
