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| Diagnostic kit of stroke volume variation in the assessment of volume expansion responses in patients undergoing liver transplantation |
| DONG Lan, AN Lina, LIU Duohui, LI Zhanjun, CAI Jungang, TAN Dianxue, CHEN Xiaoyang, and HAN Shujun |
| Department of Anesthesiology, General Hospital of Chinese People’s Armed Police Force, Beijing 100039, China |
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Abstract Objective To approach the effectiveness and diagnostic kit of stroke volume variation(SVV) in assessment of volume expansion responses in patients undergoing liver transplantation(LV).Methods 88 patients undergoing LV were selected randomly, and divided into three groups according to model for end-stage liver disease (MELD). Continuous monitoring for cardiac output was performed by arterial pressure waveform cardiac output (APCO) and mechanical ventilation (VT 8 ml/kg, respiratory rate 10-14 bpm, PEEP<10 cmH2O) was selected after intubation. Fluid therapy of 6% hydroxyethyl starch 130/0.4 8 ml/kg was infused at a rate of 0.4 ml/(kg·min). Following data, including central venous pressure (CVP), cardiac index(CI), SVV and other hemodynamic parameters, were recorded before and after fluid therapy. ΔCI 15% was taken as the criterion of volume expansion. The changing rate of CVP(ΔCVP), SVV(ΔSVV) or CI( ΔCI) was calculated. Statistical analysis of the related parameters was performed.Results Receiver operating characteristic curve (ROC) results showed that the areas under the ROC curve(AUC) for SVV were between 0.8 and 0.9 in the three groups, which were 0.855, 0.857 and 0.867, indicating that the discriminative power of SVV was credible. Moreover, the diagnostic kit was 11.5% when MELD was lower than 15, and 10.5% when it was higher than 15.Conclusions SVV is effective and helpful in assessment of volume expansion response, and it is diagnostic kit is 11.5% or 10.5% according to MELD.
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Received: 20 December 2015
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| [1] |
蒋宗明,吴秀娟,仲俊峰,等.每搏量变异和脉搏压变异用于感染性休克患者容量治疗反应的评估[J].医学研究杂志,2012,41(12):153-155.
|
| [2] |
Zimmermann M,Feibicke T,Keyl C,et al.Accuracy of stroke volume variation compared with pleth variability index to predict fluid responsiveness in mechanically ventilated patients undergoing major surgery[J].Eur J Anaesthesiol,2010,27(6):555-561.
|
| [3] |
杨秀娟,李士通.不同机械通气模式时每搏量变异度对容量治疗反应性的变化[J].上海医学,2011,34(2):145-147.
|
| [4] |
蔡勤芳,袁维秀,米卫东.不同潮气量通气患者液体治疗时每搏量变异度判断扩容效应的阈值[J].中华麻醉学杂志,2010,30(7):817-819.
|
| [5] |
Fu Q,Mi W D,Zhang H.Stroke volume variation and pleth variability index to predict fluid responsiveness during resection of primary retroperitoneal tumors in Hans Chinese[J].Biosci Trends,2012,6(1):38-43.
|
| [6] |
Suehiro K,Rinka H,Ishikawa J,et al. Stroke volume variation as a predictor of fluid responsiveness in patients undergoing airway pressure release ventilation[J].Anaesth Intensive Care,2012,40(5):767-772.
|
| [7] |
Slagt C,Helmi M,Malagon I,et al.Calibrated versus uncalibrated arterial pressure waveform analysis in monitoring cardiac output with transpulmonary thermodilution in patients with severe sepsis and septic shock:an observational study[J].Eur J Anaesthesiol,2015,32(1):5-12.
|
| [8] |
董 兰,刘多辉,安丽娜,等.FloTrac/VigileoV3.0系统在肝移植手术中的应用[J].临床麻醉学杂志,2015,31(6):550-554.
|
| [9] |
卢家凯,朱 琛,王义军.FloTrac/Vigileo系统用于冠状动脉搭桥术中血流动力学监测[J].心肺血管病杂志,2013,31(2):101-105.
|
| [10] |
王天龙.目标导向治疗引领血流动力学监测的进展[J].国际麻醉学与复苏杂志,2014,35(11):961-963.
|
| [11] |
Botta F,Giannini E,Romagnoli P,et al.MELD scoring system is useful for predicting prognosis in patients with liver cirrhosis and is correlated with residual liver function:a European study[J].Gut,2003,52(1):134-139.
|
| [12] |
王永刚,许 彪,李 雷,等.接受肝移植的晚期肝病患者高动力循环水平与MELD 评分系统的临床研究[J].中华临床医师杂志, 2013,7(24):11255-11258.
|
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2016, Vol. 27 
