■接受脑肿瘤手术切除的患者经常表现出一系列的血液动力学波动,需要仔细的液体管理。本研究旨在评估流体反应性动态预测因子的可行性,例如deltadown(DD),主动脉流速时间积分变异性(VTIAoV),上腔静脉塌陷指数(SVCCI),接受脑肿瘤神经外科手术的患者。
■在这项前瞻性研究中,纳入了30例计划接受选择性神经外科手术切除脑肿瘤的患者。生命体征的基线测量,麻醉参数,和研究变量在诱导后记录。随后,患者在20分钟内接受了10mL/kg胶体的液体推注,并在加载后重复测量。数据表示为平均值±标准偏差。正态分布的连续变量使用学生t检验进行比较,P<0.05被认为具有统计学意义。使用Pearson系数分析(r)评估变量对液体反应性的预测能力。
■在30名患者中,22人被确定为体积响应者(R),8人是无应答者(NR)。DD>5mmHg有效区分R和NR(P<0.001),具有良好的预测能力(r=0.759)。SVCCI>38%的R与NR(P<0.001),具有良好的可预测性(r=0.994)。同样,VTIAov>20%也是一个很好的预测因子(P<0.05;r=0.746)。
■我们的研究表明,大多数接受脑肿瘤手术切除的患者表现出液体反应性。在评估的变量中,SVCCI>38%是一个很好的预测指标,其次是VTIAoV>20%和DD>5mmHg,用于评估该人群的体液状态。
UNASSIGNED: Patients undergoing surgical resection of brain tumors frequently exhibit a spectrum of hemodynamic fluctuations necessitating careful fluid management. This study aimed to evaluate the feasibility of dynamic predictors of fluid responsiveness, such as delta down (DD), aortic velocity time integral variability (VTIAoV), and superior vena cava collapsibility index (SVCCI), in patients undergoing neurosurgery for brain tumors.
UNASSIGNED: In this prospective study, 30 patients scheduled to undergo elective neurosurgery for brain tumor resection were enrolled. Baseline measurements of vitals, anesthetic parameters, and study variables were recorded post-induction. Subsequently, patients received a fluid bolus of 10 mL/kg of colloid over 20 min, and measurements were repeated post-loading. Data were presented as mean ± standard deviation. The normally distributed continuous variables were compared using Student\'s t-test, with P < 0.05 considered statistically significant. The predictive capability of variables for fluid responsiveness was assessed using Pearson\'s coefficient analysis (r).
UNASSIGNED: Of the 30 patients, 22 were identified as volume responders (R), while eight were non-responders (NR). DD >5 mmHg effectively distinguished between R and NR (P < 0.001), with a good predictive ability (r = 0.759). SVCCI >38% differentiated R from NR (P < 0.001), with excellent predictability (r = 0.994). Similarly, VTIAoV >20% was also a good predictor (P < 0.05; r = 0.746).
UNASSIGNED: Our study revealed that most patients undergoing surgical resection of brain tumors exhibited fluid responsiveness. Among the variables assessed, SVCCI >38% emerged as an excellent predictor, followed by VTIAoV >20% and DD >5 mm Hg, for evaluating fluid status in this population.