为了患者安全,在手术过程中维持血液动力学的稳定性至关重要.动态指标[如收缩压变化(SPV)和脉压变化(PPV)],最近看到了使用的增加。考虑到与这种侵入性技术相关的风险,人们对无创监测方法和体积描记波形分析的兴趣日益浓厚.然而,许多这样的非侵入性方法涉及复杂的计算或品牌特定的监视器。本研究引入了简单收缩压比(SSR),来自脉搏血氧饱和度描记,作为评估液体反应性的非侵入性方法。
这项前瞻性观察性研究包括25名成人患者,他们的SPV,PPV,在开腹手术期间每隔30分钟收集SSR值。SSR被定义为脉冲描迹内最高波形与最短波形的比率。SSR之间的相关性,SPV,和PPV进行分析。此外,麻醉专家使用SSR方法目视评估脉搏血氧饱和度示踪以确定液体反应性。
SSR与SPV(r=0.715,P<0.001)和PPV(r=0.702,P<0.001)之间存在很强的相关性。接收器操作员曲线分析确定了最佳SSR阈值,用于预测SPV的液体反应性为1.47,PPV的为1.50。使用SSR方法对麻醉专家进行的一项调查以视觉评估液体反应性,其准确率为83%。
基于它与传统标记的强相关性,SSR作为临床工具具有巨大的潜力,尤其是在资源有限的环境中。然而,需要进一步的研究来确定其作用,特别是它涉及到它在监测设备的普遍适用性。
For patient safety, maintaining hemodynamic stability during surgical procedures is critical. Dynamic indices [such as systolic pressure variation (SPV) and pulse pressure variation (PPV)], have recently seen an increase in use. Given the risks associated with such invasive techniques, there is growing interest in non-invasive monitoring methods-and plethysmographic waveform analysis. However, many such non-invasive methods involve intricate calculations or brand-specific monitors. This study introduces the simple systolic ratio (SSR), derived from pulse oximetry tracings, as a non-invasive method to assess fluid responsiveness.
This prospective observational study included 25 adult patients whose SPV, PPV, and SSR values were collected at 30-min intervals during open abdominal surgery. The SSR was defined as the ratio of the tallest waveform to the shortest waveform within pulse tracings. The correlations among SSR, SPV, and PPV were analyzed. Additionally, anaesthesia specialists visually assessed pulse oximetry tracings to determine fluid responsiveness using the SSR method.
Strong correlations were observed between SSR and both SPV (r = 0.715, P < 0.001) and PPV (r = 0.702, P < 0.001). Receiver operator curve analysis identified optimal SSR thresholds for predicting fluid responsiveness at 1.47 for SPV and 1.50 for PPV. A survey of anaesthesia specialists using the SSR method to visually assess fluid responsiveness produced an accuracy rate of 83%.
Based on the strong correlations it exhibits with traditional markers, SSR has great potential as a clinical tool, especially in resource-limited settings. However, further research is needed to establish its role, especially as it pertains to its universal applicability across monitoring devices.