上半身中央静脉直径的呼吸变化作为脉搏压力变化的替代

Nichaphat Phancharoenkit, Pusit Feungfoo
{"title":"上半身中央静脉直径的呼吸变化作为脉搏压力变化的替代","authors":"Nichaphat Phancharoenkit, Pusit Feungfoo","doi":"10.54205/ccc.v30.255038","DOIUrl":null,"url":null,"abstract":"Background: Cyclical change in central vein diameter during respiratory cycle can be used for fluid-responsiveness assessment. The purpose of this study is to assess variations in the diameter of central veins in upper body region, specifically internal jugular vein (IJV), subclavian vein (SCV), and brachiocephalic vein (BCV), in mechanically ventilated patients. We hypothesized that variations in the diameter of these veins caused by passive ventilation would be strongly concordant with pulse pressure variation (PPV).\n\nMethods: The study was conducted in mechanically ventilated, critically ill surgical and medical patients. The PPV values were automatically calculated and were recorded. The diameters of the study veins such as the IJV, SCV, and BCV were measured bedside using the ultrasound. Then respiratory variations of venous diameter were calculated into distensibility index, collapsibility index and variability index. The relationships between PPV and ultrasound-derived parameters were assessed. Patients were separated into two groups according to their PPV values (>13 and <10). The test performance and proper cut-off values of ultrasound-derived parameters to distinguish between these two groups were generated by receiver operating characteristic (ROC) curves.\n\nResults: A total of 44 patients were assessed. There were substantial correlations between PPV and ultrasound parameter namely IJV-DI (r=0.652, p<0.001), IJV-VI (r=0.655, p<0.001), SCV-CI (r=0.618, p<0.001), and SCV-VI (r=0.626, p<0.001). While PPV and BCV-CI show moderate correlation (r=0.531, p=0.008). The IJV-DI, IJV-VI, SCV-CI, SCV-VI and BCV-VI values were significantly greater in PPV>13 group than PPV<10 group. All these parameters were effective in distinguishing between PPV>13 from PPV<10 group with AUC 0.983, 0.983, 0.928, 0.928 and 0.826, respectively. The IJV-DI, IJV-VI, SCV-CI, SCV-VI and BCV-VI analysis demonstrated appropriate cut-off values for separating patients with PPV>13 from those with PPV<10 as 16.19% (sensitivity 92%, specificity 96%), 14.98 % (sensitivity 92%, specificity 96%), 9.74% (sensitivity of 93%, specificity of 91%), 12.33% (sensitivity of 87%, specificity of 100%) and 13.71% (sensitivity of 73%, specificity of 100%), respectively.\n\nConclusions: In critically ill patients, all ultrasound-derived measures such as IJV-DI, IJV-VI, SCV-CI, SCV-VI, and BCV-VI revealed significant correlation with PPV value.","PeriodicalId":76963,"journal":{"name":"AACN clinical issues in critical care nursing","volume":"34 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2022-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Respiratory variation of central vein diameter in upper body as a surrogate of pulse pressure variation\",\"authors\":\"Nichaphat Phancharoenkit, Pusit Feungfoo\",\"doi\":\"10.54205/ccc.v30.255038\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Cyclical change in central vein diameter during respiratory cycle can be used for fluid-responsiveness assessment. The purpose of this study is to assess variations in the diameter of central veins in upper body region, specifically internal jugular vein (IJV), subclavian vein (SCV), and brachiocephalic vein (BCV), in mechanically ventilated patients. We hypothesized that variations in the diameter of these veins caused by passive ventilation would be strongly concordant with pulse pressure variation (PPV).\\n\\nMethods: The study was conducted in mechanically ventilated, critically ill surgical and medical patients. The PPV values were automatically calculated and were recorded. The diameters of the study veins such as the IJV, SCV, and BCV were measured bedside using the ultrasound. Then respiratory variations of venous diameter were calculated into distensibility index, collapsibility index and variability index. The relationships between PPV and ultrasound-derived parameters were assessed. Patients were separated into two groups according to their PPV values (>13 and <10). The test performance and proper cut-off values of ultrasound-derived parameters to distinguish between these two groups were generated by receiver operating characteristic (ROC) curves.\\n\\nResults: A total of 44 patients were assessed. There were substantial correlations between PPV and ultrasound parameter namely IJV-DI (r=0.652, p<0.001), IJV-VI (r=0.655, p<0.001), SCV-CI (r=0.618, p<0.001), and SCV-VI (r=0.626, p<0.001). While PPV and BCV-CI show moderate correlation (r=0.531, p=0.008). The IJV-DI, IJV-VI, SCV-CI, SCV-VI and BCV-VI values were significantly greater in PPV>13 group than PPV<10 group. All these parameters were effective in distinguishing between PPV>13 from PPV<10 group with AUC 0.983, 0.983, 0.928, 0.928 and 0.826, respectively. The IJV-DI, IJV-VI, SCV-CI, SCV-VI and BCV-VI analysis demonstrated appropriate cut-off values for separating patients with PPV>13 from those with PPV<10 as 16.19% (sensitivity 92%, specificity 96%), 14.98 % (sensitivity 92%, specificity 96%), 9.74% (sensitivity of 93%, specificity of 91%), 12.33% (sensitivity of 87%, specificity of 100%) and 13.71% (sensitivity of 73%, specificity of 100%), respectively.\\n\\nConclusions: In critically ill patients, all ultrasound-derived measures such as IJV-DI, IJV-VI, SCV-CI, SCV-VI, and BCV-VI revealed significant correlation with PPV value.\",\"PeriodicalId\":76963,\"journal\":{\"name\":\"AACN clinical issues in critical care nursing\",\"volume\":\"34 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-08-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"AACN clinical issues in critical care nursing\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.54205/ccc.v30.255038\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"AACN clinical issues in critical care nursing","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.54205/ccc.v30.255038","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

背景:呼吸周期中央静脉直径的周期性变化可用于液体反应性评估。本研究的目的是评估机械通气患者上半身区域中心静脉直径的变化,特别是颈内静脉(IJV)、锁骨下静脉(SCV)和头臂静脉(BCV)。我们假设被动通气引起的静脉直径变化与脉压变化(PPV)密切相关。方法:对机械通气、外科危重病人和内科病人进行研究。自动计算并记录PPV值。床边超声测量研究静脉(如IJV、SCV和BCV)的直径。然后将呼吸变化计算为扩张指数、溃散指数和变异性指数。评估PPV与超声衍生参数之间的关系。根据患者PPV值(>13)和PPV<10组患者PPV13与PPV13的比值分别为16.19%(敏感性92%,特异性96%)、14.98%(敏感性92%,特异性96%)、9.74%(敏感性93%,特异性91%)、12.33%(敏感性87%,特异性100%)和13.71%(敏感性73%,特异性100%)。结论:危重患者超声衍生指标IJV-DI、IJV-VI、SCV-CI、SCV-VI、BCV-VI均与PPV值有显著相关性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Respiratory variation of central vein diameter in upper body as a surrogate of pulse pressure variation
Background: Cyclical change in central vein diameter during respiratory cycle can be used for fluid-responsiveness assessment. The purpose of this study is to assess variations in the diameter of central veins in upper body region, specifically internal jugular vein (IJV), subclavian vein (SCV), and brachiocephalic vein (BCV), in mechanically ventilated patients. We hypothesized that variations in the diameter of these veins caused by passive ventilation would be strongly concordant with pulse pressure variation (PPV). Methods: The study was conducted in mechanically ventilated, critically ill surgical and medical patients. The PPV values were automatically calculated and were recorded. The diameters of the study veins such as the IJV, SCV, and BCV were measured bedside using the ultrasound. Then respiratory variations of venous diameter were calculated into distensibility index, collapsibility index and variability index. The relationships between PPV and ultrasound-derived parameters were assessed. Patients were separated into two groups according to their PPV values (>13 and <10). The test performance and proper cut-off values of ultrasound-derived parameters to distinguish between these two groups were generated by receiver operating characteristic (ROC) curves. Results: A total of 44 patients were assessed. There were substantial correlations between PPV and ultrasound parameter namely IJV-DI (r=0.652, p<0.001), IJV-VI (r=0.655, p<0.001), SCV-CI (r=0.618, p<0.001), and SCV-VI (r=0.626, p<0.001). While PPV and BCV-CI show moderate correlation (r=0.531, p=0.008). The IJV-DI, IJV-VI, SCV-CI, SCV-VI and BCV-VI values were significantly greater in PPV>13 group than PPV<10 group. All these parameters were effective in distinguishing between PPV>13 from PPV<10 group with AUC 0.983, 0.983, 0.928, 0.928 and 0.826, respectively. The IJV-DI, IJV-VI, SCV-CI, SCV-VI and BCV-VI analysis demonstrated appropriate cut-off values for separating patients with PPV>13 from those with PPV<10 as 16.19% (sensitivity 92%, specificity 96%), 14.98 % (sensitivity 92%, specificity 96%), 9.74% (sensitivity of 93%, specificity of 91%), 12.33% (sensitivity of 87%, specificity of 100%) and 13.71% (sensitivity of 73%, specificity of 100%), respectively. Conclusions: In critically ill patients, all ultrasound-derived measures such as IJV-DI, IJV-VI, SCV-CI, SCV-VI, and BCV-VI revealed significant correlation with PPV value.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信