动态动脉弹性对冠状动脉旁路移植术后患者减少去甲肾上腺素剂量后血压反应性的预测价值

doi:10.3969/j.issn.1002-1949.2017.11.011

Chinese Journal of Critical Care Medicine

2017, Vol. 37

Issue (11): 1015-1019 DOI: 10.3969/j.issn.1002-1949.2017.11.011

Dynamic arterial elastance predicts arterial pressure response when decreasing the norepinephrine dosage in shock after coronary artery bypass graft

Liang Feng-ming, Wang Qiu-hui, Xu Hong-yang, Yang Ting, Dong Liang, Jin Ke, Yan Zheng, Yan Jie

Department of Critical Care Medicine, Wuxi People′s Hospital, Nanjing Medical University, Wuxi 214023, China

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Abstract Objective: To evaluate dynamic arterial elastance (Eadyn ) as a predictor of arterial pressure response when decreasing the norepinephrine (NE) dosage in shock after coronary artery bypassgraft (CABG). Methods: A prospective observation of 82 patients suffering from shock after coronary artery bypass graft (CABG) for whom the physician planned to decrease the NE dosage was preformed. Measurements of hemodynamic and PiCCO variables were recorded before and after decreasing the NE dosage. Arterial pressure responsiveness was defined as a≥15% decrease in mean arterial pressure (MAP). The correlation between Eadyn and arterial pressure responsiveness when decreasing the NE dosage was analyzed with receiver operating characteristic (ROC) curve. Results: 82 patients with shock after CABG were conducted, with 36 in responsive group and 46 in unresponsive group. Eadyn was lower in responders than in nonresponders (P< 0.05). Eadyn≤0.96 was found to predict arterial pressure responsiveness with a sensitivity and specificity of 94.4％ and 87.0％, respectively. Conclusion: In patients with shock after CABG treated with NE, Eadyn may predict the decrease in arterial pressure when decreasing NE dose.

Received: 18 July 2017

Corresponding Authors: Wang Qiu-hui, E-mail: qiuhui4403@ sina.com

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http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949.2017.11.011 OR http://www.cnemergency.org.cn/EN/Y2017/V37/I11/1015

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