UNASSIGNED: Septic hypoperfused mechanically ventilated patients were classified as fluid responders (Rs) and non-responders (NRs) according to the improvement of left ventricular outflow tract-velocity time integral (ΔLVOT-VTI) after fluid challenge (FC). The receiver operating characteristic (ROC) curves of FC-induced ΔETCO2, pre-(FC) IJVDI and their combination for prediction of fluid responsiveness were compared to that of ΔLVOT-VTI% as a gold standard.
UNASSIGNED: Of 140 patients who completed the study, 51 (36.4%) patients were classified as Rs and 89 (63.6%) patients as NRs. With regard to the prediction of fluid responsiveness, no significant difference (P. 0. 384) was found between the diagnostic accuracy of FC-induced ΔETCO2 >2 mmHg (area under the ROC curve [AUC] 0.908, P < 0.001) and that of pre-(FC) IJVDI >18% (AUC 0.938, P < 0.001), but a prediction model combining both markers, ΔETCO2 ≥3 mmHg and IJVDI ≥16%, achieved significantly higher accuracy (AUC 0.982, P < 0.001) than each independent one (P < 0.05).
UNASSIGNED: Under stable ventilatory and metabolic conditions, the predictivity of FC-induced ΔETCO2 >2 mmHg can be comparable to that of pre-(FC) IJVDI >18%. A predictive model combining both FC-induced ΔETCO2 ≥3 mmHg and IJVDI ≥16% can provide higher accuracy than that recorded for each one independently.
■根据液体攻击(FC)后左心室流出道速度时间积分(ΔLVOT-VTI)的改善,将脓毒症低灌注机械通气患者分为液体反应者(Rs)和无反应者(NRs)。将FC诱导的ΔETCO2,pre(FC)IJVDI及其组合用于预测流体响应性的受试者工作特性(ROC)曲线与作为金标准的ΔLVOT-VTI%进行了比较。
■在完成研究的140名患者中,51例(36.4%)患者被归类为Rs,89例(63.6%)患者被归类为NRs。关于流体响应性的预测,无显著差异(P.0.384)在FC诱导的ΔETCO2>2mmHg(ROC曲线下面积[AUC]0.908,P<0.001)和前(FC)IJVDI>18%(AUC0.938,P<0.001)的诊断准确性之间发现,但是结合了两个标记的预测模型,ΔETCO2≥3mmHg,IJVDI≥16%,取得了显着更高的准确性(AUC0.982,P<0.001)比每个独立的(P<0.05)。
■在稳定的通气和代谢条件下,FC诱导的ΔETCO2>2mmHg的预测值可与(FC)IJVDI>18%的预测值相当。结合FC诱导的ΔETCO2≥3mmHg和IJVDI≥16%的预测模型可以提供比每个独立记录的更高的准确性。