Special assessment method for pulse pressure variability corrected by respiratory mechanics

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 ...

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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 the ROC curve and higher false negative (lower ΔPP in fluid responders ) and the predictive power of ΔPP did not increase significantly after Vt correction in time

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