Special assessment method for pulse pressure variability corrected by respiratory mechanics

A technology of variability and pulse, applied in the medical field, can solve the problems of no significant improvement in the prediction efficiency of ΔPP, application limitations, and low area.

Pending Publication Date: 2021-06-08
南京市高淳人民医院
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Problems solved by technology

However, in patients receiving lung protective ventilation, especially ARDS patients, the use of ΔPP is more limited; mainly manifested by lower area under t...

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  • Special assessment method for pulse pressure variability corrected by respiratory mechanics
  • Special assessment method for pulse pressure variability corrected by respiratory mechanics
  • Special assessment method for pulse pressure variability corrected by respiratory mechanics

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Embodiment Construction

[0020] The present invention will be described in further detail below in conjunction with the accompanying drawings.

[0021] When the present invention is implemented, figure 1 : ΔPP in non-ARDS patients mainly reflects the slope of the Frank-Starling curve. Specifically, in the steep segment of the Frank-Starling curve (patient 1a-b), the change in SV after fluid therapy caused a change in preload was greater (ΔSV1, belonging to fluid responders), while the patient before fluid therapy (a ) is also larger in ΔPP; and when the patient’s heart works and the flat segment of the Frank-Starling curve (patient 2c-d) the change in SV after fluid therapy leads to a change in preload is smaller (ΔSV2, belonging to fluid non-responders), In this case the patient had a smaller ΔPP before fluid therapy (c).

[0022] figure 2 : For the pulse pressure variability (ΔPP, %) corrected by intrathoracic pressure changes (ΔPpl, cmH2O), its AUC was significantly higher than the AUC value of...

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Abstract

The invention discloses a special assessment method for pulse pressure variability corrected by respiratory mechanics. The method comprises the following operation steps: (1) measuring the pulse pressure variability (delta PP) and intrathoracic pressure change (delta Ppl) numerical values of a patient; and (2) dividing the delta PP of the patient by the delta Ppl to obtain a numerical value for predicting the liquid reactivity of the patient with acute respiratory distress syndrome. Compared with the prior art, the method has the advantage that accurate judgment on the liquid reactivity of the critical patient is a treatment footstone. Delta PP is an important tool commonly used in clinic for predicting FR, but the prediction efficacy of ARDS patients is poor, the prediction accuracy can be remarkably improved through correction of esophageal pressure (Pes), the feasibility and reliability of clinical application of the parameter are greatly enhanced through introduction of a gray region, and the method has great clinical value for guiding clinical liquid management of ARDS patients and implementing precise individualized liquid treatment.

Description

technical field [0001] The invention relates to the medical field, in particular to a special evaluation method for pulse pressure variability corrected by respiratory mechanics. Background technique [0002] Fluid responsiveness (FR) is defined as the ability of the patient's heart to increase stroke volume (SV) or cardiac output (CO) after a fluid load. Patients were considered positive for FR when SV or CO increased by more than or equal to 15% compared with baseline. Pulse Pressure Variation (ΔPP) based on cardiopulmonary interaction is currently the most commonly used and most researched index in clinical practice. A lot of high-quality evidence shows that in mechanically ventilated patients with tidal volume (VT) > 8ml / kg, ΔPP can Accurately predict FR. That is, if ΔPP>=13%, the patient will respond to the fluid; otherwise, there will be no response ( figure 1 ). However, in patients receiving lung protective ventilation, especially ARDS patients, the use of ...

Claims

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Application Information

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IPC IPC(8): A61B5/021
CPCA61B5/021A61B2560/0223
Inventor 刘阳
Owner 南京市高淳人民医院
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