PETCO2变异度预测胃肠肿瘤手术患者容量反应性的准确性

Accuracy of variation of end-tidal pressure of carbon dioxide in predicting fluid responsiveness in patients undergoing resection of gastrointestinal tumor

目的评价PETCO2变异度(△PETCO2)预测胃肠肿瘤手术患者容量反应性的准确性。方法择期全身麻醉下胃肠肿瘤手术患者46例,性别不限,年龄40~64岁,BMI20~24kg/m^2,ASA分级Ⅱ或Ⅲ级。麻醉诱导后待MAP 5min内的变化小于10%时,外周静脉经10min快速输注林格液250ml。以CI增加幅度≥15%为容量反应阳性标准,绘制△PETCO2预测患者容量反应性的ROC曲线。结果ROC曲线分析结果示,△PETCO2预测患者容量反应性的曲线下面积(95%可信区间)为0.826(0.730~0.942,P<0.05),临界值为21.9%,敏感度为76.5%,特异度为90.9%。结论 △PETCO2可准确地预测胃肠肿瘤手术患者的容量反应性。

Objective To evaluate the accuracy of variation of the end-tidal pressure of carbon dioxide(△PETCO2)in predicting the fluid responsiveness in patients undergoing resection of gastrointestinal tumor.Methods Forty-six patients of both sexes,aged 40-64 yr,with body mass index of 20-24 kg/m^2,of American Society of Anesthesiologists physical statusⅡ or Ⅲ,undergoing elective resection of gastrointestinal tumor with general anesthesia,were enrolled in the study.When the change in mean arterial pressure was less than 10% within 5 min after anesthesia induction,250 ml Ringer′s solution was rapidly infused over 10 min via the peripheral vein.Increase in cardiac index after volume expansion≥15% was considered to be a positive response.The receiver operating characteristic curve for △PETCO2 in determining fluid responsiveness was drawn.Results The results of receiver operating characteristic curve analysis showed that the area under the curve for △PETCO2 in determining fluid responsiveness(95% confidence interval)was 0.826(0.730-0.942,P<0.05),the critical value 21.9%,sensitivity 76.5%,specificity 90.9%.Conclusion △PETCO2 can accurately predict the fluid responsiveness in patients undergoing resection of gastrointestinal tumor.