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Objective Using Doppler ultrasound measured in femoral artery flow velocity variation rate method to predict fluid responsiveness.Methods 80 patients were measured femoral artery flow velocity variation rate (△Vpeak)by mastering the ultrasound skills of the attending physician.Passive leg raising test (PLR)stroke vol-ume variation (△SV)was used to analyze the peak value of the femoral artery flow velocity,rate of femoral artery peak velocity of respiratory changes,and the results were compared with results of PICCO monitoring to predict patients with their response to the treatment capacity,to evaluate clinical feasibility.Results Reactive groups in the PLR test before the experiment and hemodynamic changes:PLR test reaction group in before the test and test process, HR,MAP,CAP index changes were not obvious (P >0.05),but ultrasonic detection and PICCO detection showed SV and CO varied significantly (t =15.24,P =0.00;t =13.64,P =0.00),the two kinds of methods to forecast results was consistent.In the absence of the anti should patients in PLR test before the experiment and hemodynamic chan-ges:PLR test unreacted group in before the test and test process,HR,MAP,CAP,SV and CO index change were not obvious (all P >0.05).Conclusion By ultrasonic method for measuring femoral artery flow speed variation rate can exactly evaluate the capacity status of critically ill patients,and effectively predict fluid responsiveness,the prediction results and PICOO monitoring results are highly consistent.It is a safe and efficient prediction method,which is worthy of promotion in clinical intensive observation.
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BACKGROUND: In hemodynamically unstable patients with spontaneous breathing activity, predicting volume responsivenss is a difficult challenge. Our objective was to test whether the respiratory changes in pulse oxymetry plethysmographic waveform amplitude (POP) and in stroke volume (deltaSV) could predict fluid responsiveness to passive leg raising (PLR) in normal volunteers. METHODS: We investigated 25 normal volunteers. We assessed hemodynamic status (HR, SBP, MAP, CI and SVI) and calculated the respiratory variation in pulse oximetry plethysmographic waveform amplitude at supine and after PLR. We attached a pulse oximeter of 25 spontaneously breathing volunteers as several time points: after 1 min and 5 min in supine position and during PLR at 60degrees. Heart rate, non-invasive blood pressures (mean arterial pressure, systolic blood pressure), maximal POP (POPmax), minimal POP (POPmin) and deltaPOP defined as (POPmax-POPmin)/[(POPmax+POPmin)/2] were recorded using monitor. RESULTS: Comparing to supine and PLR, systolic blood pressure and mean arterial pressure were not different, but the change in cardiac index, stroke volume and respiratory variation in POP were significant different. In response group (> or =10% in deltaCI), the change in cardiac index, stroke volume and respiratory variation in POP were significant greater. CONCLUSION: PLR induces a significant decrement of variation in POP amplitude among spontaneouely breathing volunteers. We suppose that the changes in stroke volume and the respiratory variation in pulse oximetry plethysmographic waveform amplitude induced by PLR predict fluid responsiveness in spontaneous breathing patients.