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| 非标准状态下脉压变异率评估患者容量反应性的研究进展 |
| Research progress in the assessment of volume responsiveness of patients with pluse pressure variation in non-standard states |
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| DOI：10.12089/jca.2024.03.014 |
| 中文关键词: 容量反应性 脉压变异率 非标准状态 目标导向液体治疗 |
| 英文关键词: Volume responsiveness Pulse pressure variation Non-standard state Goal-directed fluid therapy |
| 基金项目:重庆市科委面上项目（CSTB2022NSCQ-MSX0061） |
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| 中文摘要: |
| 容量反应性是目标导向液体治疗（GDFT）的核心，脉压变异率（PPV）反映每搏输出量随呼吸的变化，能够准确评估患者的容量反应性。然而，PPV监测依赖于心肺相互作用，测量时有严格的条件限制。PPV测量的标准状态要求患者接受机械通气，潮气量至少为预测体重（PBW）8 ml/kg，同时不合并自主呼吸、低肺顺应性、心律失常、胸腔开放、腹内高压和高呼吸频率等，不完全满足上述测量条件时测得的PPV则为非标准状态下PPV。临床上多数患者不满足PPV测量的标准状态，因此如何保证非标准状态下PPV应用的有效性成为当前临床研究的热点。本文综述了PPV的原理以及非标准状态下PPV的临床应用等内容，为临床合理使用PPV监测提供参考。 |
| 英文摘要: |
| Volume responsiveness is the core of goal-directed fluid therapy (GDFT), and pulse pressure variation (PPV) reflect changes in stroke volume with breathing, enabling accurate assessment of a patient's volume responsiveness. However, PPV monitoring relies on cardiopulmonary interactions, which are subject to strict conditions. The standard condition of PPV measurement requires the patient to receive mechanical ventilation with a tidal volume not less than 8 ml/kg of predicted body weight (PBW), without spontaneous breathing, low lung compliance, arrhythmia, open chest, intra-abdominal hypertension, or high respiratory rate. When the above conditions could not be fully met, the measured PPV was defined as the PPV in non-standard states. Most clinical scenarios do not meet the standard state of PPV, so how to ensure the effectiveness of PPV in non-standard states has become a hot topic in clinical research. This article reviews the principle of PPV and the clinical application of PPV in non-standard conditions, to provide a reference for clinical rational use of PPV. |
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