每搏量变异在急性非等容血液稀释中的应用

Abstract
Figure/Table
References
Related Citation (15)

Download: PDF (641 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To investigate the applicability of stroke volume variation(SVV) in acute non-normovolemic hemodilution. Methods Sixty patients were enrolled in this study who were scheduled to receive elective surgery at our hospital between March 2017 and December 2017 under general anesthesia. They were randomly divided into the control group (group C) and the observation group (group O), with 30 cases in each group. MAP, HR, SVV, hemoglobin(Hb) and hematocrit (Hct) of the two groups were recorded before blood collection (T₀), upon the collection of 100 ml of blood (T₁), 200 ml of blood (T₂), 300 ml of blood (T₃) and at the end of blood collection(T₄) respectively, so were the duration of blood collection, total colloid collection and the urine volume. Results The levels of SVV[(9.8±1.2)%] at T₄ were higher than at T₀[(5.5±1.3)%] (P＜0.05) in group O, but there was no significant difference between T₀,T₁ and T₃. The levels of MAP at T₂-T₄ were lower than at T₀ while the levels of HR at T₂-T₄ were higher than at T₀ (P＜0.05) in group C, but there was no significant difference between T₀ and T₁. The levels of Hb and HCT in group O were significantly lower than those in group C, while the total volume of blood collection and colloid collection in group O were significantly higher than those in group C(P＜0.05). Conclusions SVV monitoring can better maintain hemodynamic stability than MAP and HR, which is more conductive to acute non-normovolemic hemodilution during surgery.

Key words： stroke volume variation acute non-normovolemic hemodilution hemodynamics hydroxyethyl starch

Received: 10 August 2018

ZTFLH:

R614.1

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	LIU Xiaomei
	DONG Lan
	JIN Bing

Cite this article:

LIU Xiaomei,DONG Lan,JIN Bing. Application of stroke volume variation in acute non-normovolemic hemodilution[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2019, 30(4): 283-286.

URL:

http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2019/V30/I4/283

[1]	周慧盈,赵玮,罗蔓琳.2005年与2010年大量输血患者临床用血对比分析[J].国际检验医学杂志,2012,33(9):1075-1077.
[2]	李建华,李斌,胡惠英,等.自体血回输对骨科手术患者组织氧代谢的影响[J].临床麻醉学杂志,2013,29(4):322-324.
[3]	张干,梁大千,高涛,等.血液稀释联合自体血回输在老年患者中的应用[J].现代医学,2016,44(7):929-932.
[4]	Kumar A, Anel R, Bunnell E, et al.Pulmonary artery occlusion pressure and central venous pressure fail to predict ventricular filling volume, cardiac performance, or the response to volume infusion in normal subjects[J]. Crit Care Med, 2004,32(3):691-699.
[5]	Kelm D J,Perrin J T,Cartin C R,et al.Fulid overload in patients with severe sepsis and septic shock treated with early goal-directed therapy is associated with increased acute need for fluid-related medical interventions and hospital death[J].Shock,2015,43(1):68-73.
[6]	Khosroshahi H E,Ozkan E A,Kilic M.Arterial and left ventricular end-systolic elastance in normal children[J].Eur Rev Med Pharmacol Sci,2014,18:3260-3266.
[7]	Vincent J,Pelosi P,Pearse R,et al.Perioperative cardiovascular monitoring of high-risk patients:a consensus of 12[J].Crit Care,2015,19(5):224-236.
[8]	Martin P,Herbert S,Claudia K,et al.Preferential effects of low volume versus high volume replacement with crystalloid fluid in a hemorrhagic shock model in pigs[J].BMC Anesthesiology,2015,133(15):1-10.
[9]	Chin J H,Jun I G,Lee J,et al.Can stroke volume variation be an alternative to central venous pressure in patients undergoing kidney transplantation?[J].Transplant Proc,2014,46(10):3363-3366.
[10]	吴寒军,彭健,李靖,等.急性等容血液稀释在择期手术中的应用[J].中外医学研究,2015,13(6):39-41.
[11]	Cabrales P,Martini J ,Intaglietta M, et al. Blood viscositymar intains micro vascular conditions during normovolemic anemia independent of blood oxygen2 carrying capacity [J]. Am J Physiol Heart Circ Physiol,2015, 291(2): 581-590.
[12]	王清秀,钟和英,余开峰,等.手术患者急性等容血液稀释时血流动力学的变化[J].郧阳医学院学报,2005,24(3):137.
[13]	Derichard A,Robin E,Tavernier B, et al. Automated pulse pressure and stroke volume variations from radial artery: Evaluation during major abdominal surgery[J].Br J Anaesth,2009,103(5):678-684.
[14]	Miller T E,Roche A M,Gan T J.Poor adoption of hemodynamic optinmization during major surgery:Are we practicing substandard care[J].Anesth Analg,2011,112(6):1274-1276.
[15]	Marik P E,Baram M,Vahid B.Does central venous pressure predict fluid responsiveness? a syetematic review of the literature and the tale of seven mares [J].Chest,2008,134(1):172-178.
[16]	孟改革,方卫平,张雷,等.目标导向液体治疗下晶体液与胶体液输注对肝切除患者组织灌注和术后恢复的影响[J]. 临床麻醉学杂志,2017,33(6):557-561.
[17]	Biais M, Bernard O, Ha J C, et al .Abilities of pulse pressure variations and stroke volume variations to predict fluid responsiveness in prone position during scoliosis surgery[J].Br J Anaesth,2010,104(4):407-413.
[18]	Analo,Helena V,Carlos V,et al.The inuence of Ringer,slactate or HES130/0.4 adm in istration on the integrity of the small intestinal mucosa in a pig hemorrhagic shock model under general anesthesia[J]. J Vet Emerg Crit Care, 2016,10(4):1-12.
[19]	Marik P E,Baram M,Vahid B.Does central venous pressure predict fluid responsiveness? A syetematic review of the literature and the tale of seven mares [J].Chest,2016,134(1):172-178.
[20]	Rasmussen K C,Johnsson P,Hojskov M,et al.Hydroxyethyl starch reduces coagulation competence and increase blood loss during major surgery:results from a randomized controlled trial[J].Annals Surgery,2014,259(2):249-254.
[21]	Challand C,Struthers R,Sneyd J R,et al.Randomized controlled trail of intraoperative goal-directed fluid therapy in aerobically fit and unfit patient having major colorectal sugery[J].Br J Anaesth,2012,108(1):53-62.
[22]	李卫,刘文值,朱月皓,等.急性非等容血液稀释在脊柱手术中的应用[J].华西医学,2014,29(11):2063-2068.