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Accuracy of lung recruitment maneuver combined with brachial artery peak velocity variation in predicting fluid responsiveness / 中华麻醉学杂志
Chinese Journal of Anesthesiology ; (12): 217-220, 2020.
Article in Chinese | WPRIM | ID: wpr-869803
ABSTRACT

Objective:

To evaluate the accuracy of lung recruitment maneuver (LRM) combined with brachial artery peak velocity variation (ΔVp) in predicting fluid responsiveness.

Methods:

Sixty-four patients of both sexes, aged 18-64 yr, with body mass index 19-26 kg/m 2, of American Society of Anesthesiologists physical status Ⅰor Ⅱ, with New York Heart Association class Ⅰor Ⅱ, scheduled for elective open gastrointestinal surgery under general anesthesia, were enrolled in this study.LRM (positive airway pressure was maintained at 30 cmH 2O for 10 s) and volume loading test were performed in sequence after anesthesia induction.&Delta;Vp was measured by ultrasonography at the beginning of LRM.Mean arterial pressure (MAP), heart rate (HR), central venous pressure (CVP) and stroke volume (SV) were recorded before LRM (T 1), during LRM (T 2), before volume expansion (T 3) and after volume expansion (T 4). The changing rate of each index before and after LRM (&Delta;MAP LRM, &Delta;HR LRM, &Delta;CVP LRM, &Delta;SV LRM) and before and after volume expansion (&Delta;MAP VE, &Delta;HR VE, &Delta;CVP VE, &Delta;SV VE) were calculated.&Delta;SV VE≥15% was considered to be a positive response after volume expansion, and patients were divided into response group (≥ 15%, R group) and non-response group (< 15%, NR group).

Results:

There were 34 cases in R group and 30 cases in NR group.Compared with NR group, MAP at T 2 and SV at T 1, 2 were significantly decreased, &Delta;MAP LRM, &Delta;MAP VE, &Delta;SV LRM and &Delta;SV VE were increased, and &Delta;Vp was increased in group R ( P<0.05). There was a positive correlation between &Delta;Vp and &Delta;SV VE ( r=0.829, P<0.05), a negative correlation between &Delta;SV LRM and &Delta;SV VE ( r=-0.876, P<0.05), and a negative correlation between &Delta;Vp and &Delta;SV LRM ( r=-0.819, P<0.05). The area under the receiver operating characteristic curve of LRM combined with &Delta;Vp was 0.808, and the cut-off value was 32.3%, the sensitivity 75.3%, and the specificity 88.2%.

Conclusion:

LRM combined with &Delta;Vp (≥32.3%) can accurately predict the intraoperative fluid responsiveness in patients.
Full text: Available Index: WPRIM (Western Pacific) Type of study: Prognostic study Language: Chinese Journal: Chinese Journal of Anesthesiology Year: 2020 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Type of study: Prognostic study Language: Chinese Journal: Chinese Journal of Anesthesiology Year: 2020 Type: Article