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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2015.1
- 수록면
- 208 - 213 (6page)
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Background: In pediatric patients, dynamic preload indices to predict fluid responsiveness remain controversial. Because each beat of blood pressure (BP) — waveform — contains evidence of a systolic and diastolic time interval (STI, DTI), we compared pulse pressure variation (PPV) with respiratory STI and DTI variation (STV, DTV) as predictors of fluid responsiveness during pediatric liver transplantation. Methods: A total of 61 datasets from 16 pediatric liver transplant patients (age range one month to seven years), before and after an inferior vena cava clamp was applied, were retrospectively evaluated from electronically archived BP and central venous pressure (CVP) waveforms. STI and DTI were separated by a beat-to-beat blood pressure waveform. STV, DTV and PPV were calculated by averaging three consecutive respiratory cycles. Averaged CVP was used as a static preload index. A PPV threshold of ≥16%, a known cutoff value in pediatric surgery, was used to discriminate fluid responsiveness in the receiver operating characteristic (ROC) curve analysis. Results: PPV showed correlations with STV and DTV (r = 0.65 and 0.57, P ＜ 0.001, respectively), but not with CVP (r = −0.30, P = 0.079). The area under the ROC curves (AUC) of STV, DTV and CVP were 0.834, 0.872, and 0.613, respectively. Cut-off values of STV and DTV were 7.7% (sensitivity/specificity, 0.80/0.83) and 7.7% (sensitivity/specificity, 0.70/0.88), respectively. Conclusions: This study demonstrates that STV and DTV from a BP waveform showed the potential to predict fluid responsiveness as a surrogate of PPV during pediatric surgery.
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참고문헌 (19)
참고문헌 신청
곽영란 / 2013 / 수액요법 시의 감시장치 / Anesthesia and Pain Medicine 8(1):1~8
Byon HJ / 2013 / Prediction of fluid responsiveness in mechanically ventilated children undergoing neurosurgery / Br J Anaesth 110:586~591
Choi DY / 2010 / Respiratory variation in aortic blood flow velocity as a predictor of fluid responsiveness in children after repair of ventricular septal defect / Pediatr Cardiol 31:1166~1170
Julien F / 2013 / Plethysmographic variability index (PVI) accuracy in predicting fluid responsiveness in anesthetized children / Paediatr Anaesth 23:536~546
Tran H / 2007 / Variation in blood pressure as a guide to volume loading in children following cardiopulmonary bypass / J Clin Monit Comput 21:1~6
Byon HJ / 2013 / Prediction of fluid responsiveness in mechanically ventilated children undergoing neurosurgery / Br J Anaesth 110:586~591
Choi DY / 2010 / Respiratory variation in aortic blood flow velocity as a predictor of fluid responsiveness in children after repair of ventricular septal defect / Pediatr Cardiol 31:1166~1170
Julien F / 2013 / Plethysmographic variability index (PVI) accuracy in predicting fluid responsiveness in anesthetized children / Paediatr Anaesth 23:536~546
Tran H / 2007 / Variation in blood pressure as a guide to volume loading in children following cardiopulmonary bypass / J Clin Monit Comput 21:1~6
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