التفاصيل البيبلوغرافية
| العنوان: |
Trendelenburg maneuver predicts fluid responsiveness in patients on veno-arterial extracorporeal membrane oxygenation |
| المؤلفون: |
Jing-chao Luo, Ying Su, Li-li Dong, Jun-yi Hou, Xin Li, Ying Zhang, Guo-guang Ma, Ji-li Zheng, Guang-wei Hao, Huan Wang, Yi-jie Zhang, Zhe Luo, Guo-wei Tu |
| المصدر: |
Annals of Intensive Care, Vol 11, Iss 1, Pp 1-10 (2021) |
| بيانات النشر: |
SpringerOpen, 2021. |
| سنة النشر: |
2021 |
| المجموعة: |
LCC:Medical emergencies. Critical care. Intensive care. First aid |
| مصطلحات موضوعية: |
Fluid responsiveness, Trendelenburg maneuver, Veno-arterial extracorporeal membrane oxygenation, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9 |
| الوصف: |
Abstract Background Evaluation of fluid responsiveness during veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support is crucial. The aim of this study was to investigate whether changes in left ventricular outflow tract velocity–time integral (ΔVTI), induced by a Trendelenburg maneuver, could predict fluid responsiveness during VA-ECMO. Methods This prospective study was conducted in patients with VA-ECMO support. The protocol included four sequential steps: (1) baseline-1, a supine position with a 15° upward bed angulation; (2) Trendelenburg maneuver, 15° downward bed angulation; (3) baseline-2, the same position as baseline-1, and (4) fluid challenge, administration of 500 mL gelatin over 15 min without postural change. Hemodynamic parameters were recorded at each step. Fluid responsiveness was defined as ΔVTI of 15% or more, after volume expansion. Results From June 2018 to December 2019, 22 patients with VA-ECMO were included, and a total of 39 measurements were performed. Of these, 22 measurements (56%) met fluid responsiveness. The R 2 of the linear regression was 0.76, between ΔVTIs induced by Trendelenburg maneuver and the fluid challenge. The area under the receiver operating characteristic curve of ΔVTI induced by Trendelenburg maneuver to predict fluid responsiveness was 0.93 [95% confidence interval (CI) 0.81–0.98], with a sensitivity of 82% (95% CI 60–95%), and specificity of 88% (95% CI 64–99%), at a best threshold of 10% (95% CI 6–12%). Conclusions Changes in VTI induced by the Trendelenburg maneuver could effectively predict fluid responsiveness in VA-ECMO patients. Trial registration ClinicalTrials.gov, NCT 03553459 (the TEMPLE study). Registered on May 30, 2018 |
| نوع الوثيقة: |
article |
| وصف الملف: |
electronic resource |
| اللغة: |
English |
| تدمد: |
2110-5820 |
| Relation: |
https://doaj.org/toc/2110-5820 |
| DOI: |
10.1186/s13613-021-00811-x |
| URL الوصول: |
https://doaj.org/article/9fe4cbd57e2842b1ad1b7216f328f45f |
| رقم الانضمام: |
edsdoj.9fe4cbd57e2842b1ad1b7216f328f45f |
| قاعدة البيانات: |
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