رسالة جامعية
Do changes in perfusion index reflect changes in stroke volume during preload-modifying manoeuvres? ; Les variations de l'indice de perfusion périphérique reflètent-elles les variations du volume d'éjection systolique au cours d'une manœuvre de recrutement alvéolaire ?
| العنوان: | Do changes in perfusion index reflect changes in stroke volume during preload-modifying manoeuvres? ; Les variations de l'indice de perfusion périphérique reflètent-elles les variations du volume d'éjection systolique au cours d'une manœuvre de recrutement alvéolaire ? |
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| المؤلفون: | Chavigner, Camille |
| المساهمون: | Université de Bordeaux (UB), Hugues de Courson |
| المصدر: | https://dumas.ccsd.cnrs.fr/dumas-03971574Test ; Sciences du Vivant [q-bio]. 2022. |
| بيانات النشر: | HAL CCSD |
| سنة النشر: | 2022 |
| المجموعة: | DUMAS (Dépôt Universitaire de Mémoires Après Soutenance) |
| مصطلحات موضوعية: | Perfusion index, Pulse oxymeter, Lung recruitement manoeuvre, Fluid responsiveness, Cardiac output, Indice de perfusion, Oxymètre de pouls, Manœuvre de recrutement alvéolaire, Prédiction du remplissage, Débit cardiaque, [SDV]Life Sciences [q-bio], [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
| الوصف: | Background: changes in stroke volume (deltaSV) induced by a lung recruitment manoeuvre (LRM) have been shown to accurately predict fluid responsiveness during protective mechanical ventilation. Cardiac output monitors are used in a limited number of surgical patients. In contrast, all patients are monitored with a pulse oximeter, that may enable the continuous monitoring of a peripheral perfusion index (PI). We postulated that changes in PI (deltaPI) may reflect deltaSV during brief modifications of cardiac preload. Methods: we studied 47 patients undergoing neurosurgery and ventilated with a tidal volume of 6–8 ml/kg. All patients were monitored with a pulse contour system enabling the continuous monitoring of SV and with a pulse oximeter enabling the continuous monitoring of PI. LRMs were performed by increasing airway pressure up to 30 cmH20 for 30 s. Fluid loads (250 ml of saline 0.9% in 10 min) were performed only in patients who experienced a deltaSV>30% during LRMs (potential fluid responders). Results: LRMs induced a 26% decrease in SV (p < 0.05) and a 27% decrease in PI (p < 0.05). We observed a fair relationship between deltaPI and deltaSV (r2= 0.34). A deltaPI ≥ 26% predicted a deltaSV > 30% with a sensitivity of 83% and a specificity of 78% (AUC = 0.84, 95%CI 0.71–0.93). 24 patients experienced a deltaSV > 30% and subsequently received fluid. Fluid loads induced a 16% increase in SV and a 17% increase in PI, but fluid-induced deltaPI and deltaSV were weakly correlated (r2= 0.19). Conclusion: in neurosurgical patients, we conclude that deltaPI may be used as a surrogate for deltaSV during LRMs but not during fluid loading. ; Introduction : les variations du VES induites par une manœuvre de recrutement alvéolaire ont démontré leur capacité à prédire la réponse au remplissage chez les patients sous ventilation protectrice. Les moniteurs du débit cardiaque sont utilisés dans un nombre de cas limité pour nos patients chirurgicaux. Alors que l’ensemble de nos patients sont nécessairement ... |
| نوع الوثيقة: | master thesis |
| اللغة: | French |
| العلاقة: | dumas-03971574; https://dumas.ccsd.cnrs.fr/dumas-03971574Test; https://dumas.ccsd.cnrs.fr/dumas-03971574/documentTest; https://dumas.ccsd.cnrs.fr/dumas-03971574/file/Med_spe_2022_Chavigner.pdfTest |
| الإتاحة: | https://dumas.ccsd.cnrs.fr/dumas-03971574Test https://dumas.ccsd.cnrs.fr/dumas-03971574/documentTest https://dumas.ccsd.cnrs.fr/dumas-03971574/file/Med_spe_2022_Chavigner.pdfTest |
| حقوق: | info:eu-repo/semantics/OpenAccess |
| رقم الانضمام: | edsbas.817FB91C |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |