被动抬腿试验全国会.pptVIP

A Linear regression analysis of the relationship between PLR-induced changes in cardiac output and PETCO2. PETCO2, partial end-tidal CO2?pressure; PLR, passive leg raising. B Linear regression analysis of the relationship between cardiac output changes induced by volume expansion and PLR-induced changes in cardiac output and PETCO2. CO, cardiac output; PLR, passive leg raising; VE, volume expansion. C Individual values and box-plot of studied fluid-responsiveness parameter in responders (open circles) and non-responders (closed circles). ΔCOPLR, cardiac output changes induced by passive leg raising (PLR); ΔPETCO2-PLR?= PETCO2?changes induced by PLR; ΔPP-PLR, arterial pulse pressure changes induced by PLR; FTc: corrected flow time at pre-infusion time. Comparison of receiver operating characteristics curves regarding the ability of studied fluid responsiveness parameters to discriminate responder patients (cardiac output increase ≥ 15%) and nonresponder patients after volume expansion. ΔCOPLR, cardiac output changes induced by passive leg raising (PLR); ΔPETCO2-PLR, PETCO2?changes induced by PLR; ΔPP-PLR, arterial pulse pressure changes induced by PLR; FTc: corrected flow time at pre-infusion time. * 在带自主呼吸模式的机械通气病人中，被动抬腿法和快速液体负荷法相比较。每个病人采用被动抬腿法记录ABF（主动脉血流，是食道超声下一个类似CO的参数）和PP增加值，然后每个病人输入500ml液体，记录输液后ABF的增加值。根据ABF增加值分△ABF＜15%（无输液反应）和△ABF≥15%（有输液反应）这2组，再回顾输液前被动抬腿记录的ABF和PP增加值，发现在输液后ABF大于15％的病人中他们的被动抬腿引起的ABF增加值都大于10％，而那些在输液后ABF小于15％的病人中他们的被动抬腿引起的ABF增加值都小于10％，被动抬腿和快速补液呈现良好的相关性。而右边的记录抬腿后PP的增加值与输液反应相比较，其精确度和灵敏度低于前者。 * 在无机械通气的自主呼吸病人中，被动抬腿法和快速液体负荷法相比较。每个病人采用被动抬腿法记录CO和SV增加值，然后每个病人输入500ml液体，记录输液后CO的增加值。根据CO增加值分△CO＜12%（无输液反应）和△CO≥12%（有输液反应）这2组，再回顾输液前被动抬腿记录的CO和SV增加值，发现在输液后CO大于12％的病人中他们的被动抬腿引起的CO和SV增加值大多都大于12％，而那些在输液后CO小于12％的病人中他们的被动抬腿引起的CO和SV增加值都小于12％，被动抬腿和快速补液呈现良好的相关性。而被动抬腿中CO和SV增加值应相比较，SV的精确度和灵敏度高于CO。 和传统CPR相比，在CPR过程中进行PLR，按压速率为100-120次/min ,下肢抬高 45度，可显著提高CO/SPP/CPP。 * Figure 2. Receiver-operating characteristic curves comparing the capacity of changes induced by p