■超声剪切波弹性成像(SWE)是一种新颖的技术,可以提供对肾脏顺应性的非侵入性测量。我们旨在研究静脉(IV)液体给药与SWE测量值变化之间的关系。我们假设健康志愿者静脉输液后,整体肾脏硬度会增加,这种硬度的增加可以使用SWE进行量化.我们的第二个假设是,静脉输液的渐变剂量会导致SWE测量的整体肾脏硬度的剂量依赖性增加。
■随机前瞻性研究。
■重症监护病房。
■18-40岁的健康志愿者。
■参与者随机接受20毫升/千克,30ml/kg,或40毫升/千克生理盐水。输注的流体的体积基于记录的实际体重。
■我们记录了平均SWE刚度(kPa,平均值为标准偏差),中值SWE刚度(kPa),和四分位数范围。
■98%的参与者(44/45)在静脉输液后表现出整体肾硬度增加。流体施用前的平均SWE为7.572kPa±2.38,而流体施用后为14.9kPa±4.81(p<0.001)。在亚组分析中,每次液体给药(ml/kg)前后,整体肾脏硬度均有显著变化.比较三组间整体肾脏硬度相对于基线的平均百分比变化。比较第1组和第2组时没有显着差异(197.1%增加±49.5vs216.1%±72.0,p?0.398),第2组和第3组(216.1%增加±72.0vs197.8%±59.9,p?0.455),或第1组和第3组(197.1%增加±49.5vs197.8%±59.9,p?0.972)。
■流体给药导致在所有输注体积的流体中整体肾硬度立即可见且可量化的变化。
UNASSIGNED: Ultrasound shear wave elastography (SWE) is a novel technique that may provide non-invasive measurements of renal compliance. We aimed to investigate the relationship between intravenous (IV) fluid administration and change in SWE measurements. We hypothesised that following IV fluid administration in healthy volunteers, global kidney stiffness would increase and that this increase in stiffness could be quantified using SWE. Our second hypothesis was that graduated doses of IV fluids would result in a dose-dependent increase in global kidney stiffness measured by SWE.
UNASSIGNED: Randomised prospective study.
UNASSIGNED: Intensive Care Unit.
UNASSIGNED: Healthy volunteers aged 18-40 years.
UNASSIGNED: Participants were randomised to receive 20 ml/kg, 30 ml/kg, or 40 ml/kg of normal saline. The volume of fluid infused was based on the actual body weight recorded.
UNASSIGNED: We recorded average SWE stiffness (kPa with standard deviation of the mean), median SWE stiffness (kPa), and the interquartile range.
UNASSIGNED: Ninety-eight percent of participants (44/45) demonstrated an increase in global kidney stiffness following administration of IV fluids. The average SWE pre fluid administration was 7.572 kPa ± 2.38 versus 14.9 kPa ± 4.81 post fluid administration (p < 0.001). In subgroup analysis, there were significant changes in global kidney stiffness pre and post fluid administration with each volume (ml/kg) of fluid administered. Average percentage change in global kidney stiffness from baseline was compared between the three groups. There was no significant difference when comparing groups 1 and 2 (197.1% increase ± 49.5 vs 216.1% ± 72.0, p ¼ 0.398), groups 2 and 3 (216.1% increase ± 72.0 vs 197.8% ± 59.9, p ¼ 0.455), or groups 1 and 3 (197.1% increase ± 49.5 vs 197.8% ± 59.9, p ¼ 0.972).
UNASSIGNED: Fluid administration results in immediately visible and quantifiable changes in global kidney stiffness across all infused volumes of fluid.