床旁超声测量下腔静脉呼吸变异指数对脓毒症休克机械通气患者容量反应性的评估

doi:10.7517/issn.1674-0475.200208

影像科学与光化学 ›› 2020, Vol. 38 ›› Issue (5): 811-814.DOI: 10.7517/issn.1674-0475.200208

床旁超声测量下腔静脉呼吸变异指数对脓毒症休克机械通气患者容量反应性的评估

姚喜庆, 李吉光, 任盼盼, 王言理

连云港市第一人民医院, 江苏连云港 222061

收稿日期:2020-02-27 出版日期:2020-09-15 发布日期:2020-09-15

POCUS Measured of Respiratory Variability Index in Evaluation of the Volume Responsiveness in Mechanical Ventilation Patients with Septic Shock

YAO Xiqing, LI Jiguang, REN Panpan, WANG Yanli

Department of EICU, The First People's Hospital of Lianyungang, Lianyungang 222061, Jiangsu, P. R. China

Received:2020-02-27 Online:2020-09-15 Published:2020-09-15

摘要/Abstract

摘要： 本研究分析了床旁超声（POCUS）测量下腔静脉呼吸变异指数（RVI）在脓毒症休克（SS）机械通气患者容量反应性（VR）评估中的应用价值。对70例行机械通气的SS患者进行补液试验，以补液试验后的心脏指数（CI）增加≥15%为容量有反应（研究组）39例，<15%为容量无反应（对照组）31例。所有患者均行床旁超声监测，测量补液前后吸气末下腔静脉最大直径（D_max）、呼气末下腔静脉最小直径（D_min），并计算RVI。补液后，研究组RVI明显降低（P<0.05）。研究组RVI与CI显著相关（P<0.05）。RVI预测SS机械通气患者VR的AUC、敏感度、特异性均高于D_max、D_min（P<0.05）。RVI与VR显著相关，POCUS测量RVI可作为一种预测SS机械通气患者VR的无创检测手段。

关键词: 脓毒症休克, 机械通气, 床旁超声, 下腔静脉呼吸变异指数, 容量反应性

Abstract: The application value of Point-of-care Ultrasound (POCUS) measured of respiratory variability index (RVI) in evaluation of the volume responsiveness (VR) in mechanical ventilation patients with septic shock (SS) is analyzed in this study. 70 patients with mechanical ventilation and SS were given rehydration test. Patients were divided into responsive (study group) 39 cases and non-responsive (control group) 31 cases according to cardiac index (CI) increased ≥ 15% or <15% after rehydration test. All patients were monitored by POCUS, the maximum diameter of IVC at end-inspiratory (D_max) and minimum diameter of IVC at end-expiratory (D_min) were measured before and after rehydration test, and RVI was calculated. After the rehydration test, RVI of the study group was significantly decreased (P<0.05). RVI of the study group was significantly correlation with CI (P<0.05). The AUC, sensitivity and specificity of RVI in predictive the VR of mechanical ventilation patients with SS were 811 higher than those of the D_max and D_min (P<0.05). Therefore, the RVI was significantly correlation with VR. POCUS measured of RVI can be used as a noninvasive method in predictive the VR of mechanical ventilation patients with SS.

Key words: septic shock, mechanical ventilation, point-of-care ultrasound, respiratory variability index, volume responsiveness

姚喜庆, 李吉光, 任盼盼, 王言理. 床旁超声测量下腔静脉呼吸变异指数对脓毒症休克机械通气患者容量反应性的评估[J]. 影像科学与光化学, 2020, 38(5): 811-814.

YAO Xiqing, LI Jiguang, REN Panpan, WANG Yanli. POCUS Measured of Respiratory Variability Index in Evaluation of the Volume Responsiveness in Mechanical Ventilation Patients with Septic Shock[J]. Imaging Science and Photochemistry, 2020, 38(5): 811-814.

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床旁超声测量下腔静脉呼吸变异指数对脓毒症休克机械通气患者容量反应性的评估

POCUS Measured of Respiratory Variability Index in Evaluation of the Volume Responsiveness in Mechanical Ventilation Patients with Septic Shock

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