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Abstract：
Respiratory variation in the internal jugular vein (IJVV) has not shown promising results in predicting volume responsiveness in ventilated patients with low tidal volume (Vt) in prone position. We aimed to determine whether the baseline respiratory variation in the IJVV value measured by ultrasound might predict fluid responsiveness in patients with adolescent idiopathic scoliosis (AIS) undergoing posterior spinal fusion (PSF) with low Vt.
According to the fluid responsiveness results, the included patients were divided into two groups: those who responded to volume expansion, denoted the responder group, and those who did not respond, denoted the non-responder group. The primary outcome was determination of the value of baseline IJVV in predicting fluid responsiveness (≥15% increases in stroke volume index (SVI) after 7 ml·kg-1 colloid administration) in patients with AIS undergoing PSF during low Vt ventilation. Secondary outcomes were estimation of the diagnostic performance of pulse pressure variation (PPV), stroke volume variation (SVV), and the combination of IJVV and PPV in predicting fluid responsiveness in this surgical setting. The ability of each parameter to predict fluid responsiveness was assessed using a receiver operating characteristic curve.
Fifty-six patients were included, 36 (64.29%) of whom were deemed fluid responsive. No significant difference in baseline IJVV was found between responders and non-responders (25.89% vs. 23.66%, p = 0.73), and no correlation was detected between baseline IJVV and the increase in SVI after volume expansion (r = 0.14, p = 0.40). A baseline IJVV greater than 32.00%, SVV greater than 14.30%, PPV greater than 11.00%, and a combination of IJVV and PPV greater than 64.00% had utility in identifying fluid responsiveness, with a sensitivity of 33.33%, 77.78%, 55.56%, and 55.56%, respectively, and a specificity of 80.00%, 50.00%, 65.00%, and 65.00%, respectively. The area under the receiver operating characteristic curve for the baseline values of IJVV, SVV, PPV, and the combination of IJVV and PPV was 0.52 (95% CI, 0.38-0.65, p=0.83), 0.54 (95% CI, 0.40-0.67, p=0.67), 0.58 (95% CI, 0.45-0.71, p=0.31), and 0.57 (95% CI, 0.43-0.71, p=0.37), respectively.
Ultrasonic-derived IJVV lacked accuracy in predicting fluid responsiveness in patients with AIS undergoing PSF during low Vt ventilation. In addition, the baseline values of PPV, SVV, and the combination of IJVV and PPV did not predict fluid responsiveness in this surgical setting.
This trial was registered at www.chictr.org (ChiCTR2200064947) on 24/10/2022. All data were collected through chart review.
According to the fluid responsiveness results, the included patients were divided into two groups: those who responded to volume expansion, denoted the responder group, and those who did not respond, denoted the non-responder group. The primary outcome was determination of the value of baseline IJVV in predicting fluid responsiveness (≥15% increases in stroke volume index (SVI) after 7 ml·kg-1 colloid administration) in patients with AIS undergoing PSF during low Vt ventilation. Secondary outcomes were estimation of the diagnostic performance of pulse pressure variation (PPV), stroke volume variation (SVV), and the combination of IJVV and PPV in predicting fluid responsiveness in this surgical setting. The ability of each parameter to predict fluid responsiveness was assessed using a receiver operating characteristic curve.
Fifty-six patients were included, 36 (64.29%) of whom were deemed fluid responsive. No significant difference in baseline IJVV was found between responders and non-responders (25.89% vs. 23.66%, p = 0.73), and no correlation was detected between baseline IJVV and the increase in SVI after volume expansion (r = 0.14, p = 0.40). A baseline IJVV greater than 32.00%, SVV greater than 14.30%, PPV greater than 11.00%, and a combination of IJVV and PPV greater than 64.00% had utility in identifying fluid responsiveness, with a sensitivity of 33.33%, 77.78%, 55.56%, and 55.56%, respectively, and a specificity of 80.00%, 50.00%, 65.00%, and 65.00%, respectively. The area under the receiver operating characteristic curve for the baseline values of IJVV, SVV, PPV, and the combination of IJVV and PPV was 0.52 (95% CI, 0.38-0.65, p=0.83), 0.54 (95% CI, 0.40-0.67, p=0.67), 0.58 (95% CI, 0.45-0.71, p=0.31), and 0.57 (95% CI, 0.43-0.71, p=0.37), respectively.
Ultrasonic-derived IJVV lacked accuracy in predicting fluid responsiveness in patients with AIS undergoing PSF during low Vt ventilation. In addition, the baseline values of PPV, SVV, and the combination of IJVV and PPV did not predict fluid responsiveness in this surgical setting.
This trial was registered at www.chictr.org (ChiCTR2200064947) on 24/10/2022. All data were collected through chart review.
摘要：
背景：颈内静脉（IJVV）的呼吸变异在预测俯卧位低潮气量（Vt）的通气患者的容量反应性方面没有显示出有希望的结果。我们旨在确定通过超声测量的IJVV值的基线呼吸变化是否可以预测接受低Vt后路脊柱融合术（PSF）的青少年特发性脊柱侧凸（AIS）患者的液体反应性。
方法：根据流体响应性结果，纳入的患者分为两组：对容量扩张有反应的患者，表示响应者组，那些没有回应的人，表示为非响应者组。主要结果是确定基线IJVV在预测低Vt通气期间接受PSF的AIS患者的液体反应性（7ml·kg-1胶体给药后每搏输出量指数（SVI）增加≥15％）中的值。次要结果是评估脉压变化（PPV）的诊断性能，每搏输出量变化(SVV),以及IJVV和PPV的组合在预测这种手术环境中的液体反应性。使用受试者工作特性曲线评估每个参数预测流体反应性的能力。
结果：纳入56例患者，其中36人（64.29%）被认为是流体敏感的。应答者和非应答者之间的基线IJVV没有显着差异（25.89％vs.23.66%,p=0.73),基线IJVV与体积扩张后SVI的增加无相关性(r=0.14,p=0.40).基线IJVV大于32.00%,SVV大于14.30%，PPV大于11.00%,IJVV和PPV的组合大于64.00%在识别液体反应性方面具有实用性，灵敏度为33.33%，77.78%,55.56%,55.56%，分别,特异性为80.00%，50.00%,65.00%,65.00%，分别。IJVV基线值的接收器工作特性曲线下的面积，SVV,PPV,IJVV和PPV的组合为0.52（95％CI，0.38-0.65，p=0.83），0.54（95%CI，0.40-0.67，p=0.67），0.58（95%CI，0.45-0.71，p=0.31），和0.57（95%CI，0.43-0.71，p=0.37），分别。
结论：超声衍生的IJVV在预测低Vt通气期间接受PSF的AIS患者的液体反应性方面缺乏准确性。此外,PPV的基线值，SVV,IJVV和PPV的组合不能预测这种手术环境中的液体反应性.
背景：该试验已在www注册。chictr.org(ChiCTR2200064947)，2022年10月24日。所有数据均通过图表审查收集。
方法：根据流体响应性结果，纳入的患者分为两组：对容量扩张有反应的患者，表示响应者组，那些没有回应的人，表示为非响应者组。主要结果是确定基线IJVV在预测低Vt通气期间接受PSF的AIS患者的液体反应性（7ml·kg-1胶体给药后每搏输出量指数（SVI）增加≥15％）中的值。次要结果是评估脉压变化（PPV）的诊断性能，每搏输出量变化(SVV),以及IJVV和PPV的组合在预测这种手术环境中的液体反应性。使用受试者工作特性曲线评估每个参数预测流体反应性的能力。
结果：纳入56例患者，其中36人（64.29%）被认为是流体敏感的。应答者和非应答者之间的基线IJVV没有显着差异（25.89％vs.23.66%,p=0.73),基线IJVV与体积扩张后SVI的增加无相关性(r=0.14,p=0.40).基线IJVV大于32.00%,SVV大于14.30%，PPV大于11.00%,IJVV和PPV的组合大于64.00%在识别液体反应性方面具有实用性，灵敏度为33.33%，77.78%,55.56%,55.56%，分别,特异性为80.00%，50.00%,65.00%,65.00%，分别。IJVV基线值的接收器工作特性曲线下的面积，SVV,PPV,IJVV和PPV的组合为0.52（95％CI，0.38-0.65，p=0.83），0.54（95%CI，0.40-0.67，p=0.67），0.58（95%CI，0.45-0.71，p=0.31），和0.57（95%CI，0.43-0.71，p=0.37），分别。
结论：超声衍生的IJVV在预测低Vt通气期间接受PSF的AIS患者的液体反应性方面缺乏准确性。此外,PPV的基线值，SVV,IJVV和PPV的组合不能预测这种手术环境中的液体反应性.
背景：该试验已在www注册。chictr.org(ChiCTR2200064947)，2022年10月24日。所有数据均通过图表审查收集。
