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«Вестник анестезиологии и реаниматологии» Том 14, №3, 2017,

DOI : 10.21292/2078-5658-2017-14-3-25-34

Прогнозирование ответа на инфузионную нагрузку: современные подходы и перспективы

Я. Ю. Ильина , В. В. Кузьков , Е. В. Фот , А. А. Смёткин , М. Ю. Киров

  • Северный государственный медицинский университет, г. Архангельск, Россия

Инфузионная нагрузка является одним из ключевых компонентов целенаправленной терапии критических состояний. Целенаправленный подход позволяет оптимизировать сердечный выброс, улучшить доставку кислорода к тканям и его утилизацию клетками. Динамические параметры преднагрузки и функциональные тесты дают возможность прогнозировать ранний ответ гемодинамики на введение жидкости, что позволяет рекомендовать их в качестве ориентира для оптимизации инфузионной терапии.

Ключевые слова: инфузионная терапия, сердечный выброс, доставка кислорода, шок

Литература

  • 1. Кузьков В. В., Киров М. Ю. Инвазивный мониторинг гемодинамики: монография. – Архангельск: Северный государственный медицинский университет, 2015. – 392 с.
  • 2. Лебединский К. М. Кровообращение и анестезия. Оценка и коррекция системной гемодинамики во время операции и анестезии. – 2-е изд., испр. – СПб.: Человек, 2015. – 1076 с.
  • 3. Лихванцев В. В. Инфузионная терапия в периоперационном периоде // Вестн. анестезиол. и реаниматол. – 2016.– № 5.– С. 66–73.
  • 4. Benington S., Ferris P., Nirmalan M. Emerging trends in minimally invasive haemodynamic monitoring and optimization of fluid therapy // Eur. J. Anaesthesiol. – 2009. – Vol. 26. – P. 893–905.
  • 5. Buettne M., Schummer W., Huettemann E. еt al. Influence of systolic-pressure-variation-guided intraoperative fluid management on organ function and oxygen transport // Br. J. Anaesth. – 2008. – Vol. 101. – P. 194–199.
  • 6. Carsetti A., Cecconi M., Rhodes A. Fluid bolus therapy: monitoring and predicting fluid responsiveness // Curr. Opin. Crit. Care. – 2015. – Vol. 21. – P. 388–394.
  • 7. Cannesson M., Aboy M., Hofer C. K. et al. Pulse pressure variation: Where are we today // J. Clin. Monit. Comput. – 2010. – Vol. 25. – P. 45–56.
  • 8. Cavallaro F., Sandroni C., Antonelli M. Functional hemodynamic monitoring and dynamic indices of fluid responsiveness // Minerva Anesthesiol. – 2008. –Vol. 74. – P. 123–135.
  • 9. Cecconi M., Parsons A. K., Rhodes A. What is a fluid challenge? // Curr. Opin. Crit. Care. – 2011. – Vol. 17. – P. 290–295.
  • 10. Cecconi M., Aya H. D., Geisen M. et al. Changes in the mean systemic filling pressure during a fluid challenge in postsurgical intensive care patients // Intens. Care Med. – 2013. – Vol. 39. – P. 1299–1305.
  • 11. Cecconi M., Monge Garcia M. I., Gracia R. M. et al. The use of pulse pressure variation and stroke volume variation in spontaneouslybreathing patients to assess dynamic arterial elastance and to predict arterial pressure response to fluid administration // Anesth. Analg. – 2015. – Vol. 120. – P. 76–84.
  • 12. Coriat P., Vrillon M., Perel A. et al. A comparison of systolic blood pressure variations and echocardiographic estimates of end-diastolic left ventricular size in patients after aortic surgery // Anesth. Analg. – 1994. – Vol. 78. – P. 46–53.
  • 13. de Backer D., Heenen S., Piagnerelli M. et al. Pulse pressure variations to predict fluid responsiveness: influence of tidal volume // Intens. Care Med. – 2005. – Vol. 31. – P. 517–523.
  • 14. de Backer D., Pinsky M. R. Can one predict fluid responsiveness in spontaneously breathing patients // Intens. Care Med. – 2007. – Vol. 33. – P. 1111–1113.
  • 15. Donati A., Carsetti A., Damiani E. et al. Fluid responsiveness in critically ill patients // Indian. J. Crit. Care Med. – 2015. – Vol. 19. – P. 375–376.
  • 16. Endo T., Kushimoto S., Yamanouchi S. et al. Limitations of global end-diastolic volume index as a parameter of cardiac preload in the early phase of severe sepsis: a subgroup analysis of a multicenter, prospective observational study // J. Intens. Care. – 2013. – Vol. 1. – P. 11.
  • 17. Guinot P.-G., Bernard E., Defrancq F. et al. Mini-fluid challenge predicts fluid responsiveness during spontaneous breathing under spinal anaesthesia // Eur. J. Anaesthesiol. – 2014. – Vol. 11. – P. 41–47.
  • 18. Heenen S., de Backer D., Vincent J. L. How can the response to volume expansion in patients with spontaneous respiratory movements be predicted // Crit. Care. – 2006. – Vol. 10 – P. 102.
  • 19. Hofer C. K., Cannesson M. Monitoring fluid responsiveness // Acta Anaesthesiol Taiwan. – 2011. – Vol. 49. – P. 59–65.
  • 20. Kelm D. J., Perrin J. T., Cartin-Ceba R. et al. Fluid overload in patients with severe sepsis and septic shock treated with early goal-directed therapy is associated with increased acute need for fluid-related medical interventions and hospital death // Shock. – 2015. – Vol. 43. – P. 68–73.
  • 21. Lee J., de Louw E., Niemi M. et al. Association between fluid balance and survival in critically ill patients // J. Intern. Med. – 2015. – Vol. 277. – P. 468–477.
  • 22. Lopes M. R., Oliveira M. A., Pereira V. O. et al. Goal-directed fluid management based on pulse pressure variations monitoring during high-risk surgery: a pilot randomized controlled trial // Crit. Care. – 2007. – Vol. 11. – P. 100.
  • 23. Magder S. Clinical usefulness of respiratory variations in arterial pressure // Am. J. Respir. Crit. Care Med. – 2004. – Vol. 169. – P. 151–155.
  • 24. Marik P. E., Cavallazzi R., Vasu T. et al. Dynamic changes in arterial waveform derived variables and fluid responsiveness in mechanically ventilated patients: a systematic review of the literature // Crit. Care Med. – 2009. – Vol. 37. – P. 2642–2647.
  • 25. Michard F., Teboul J. L. Predicting fluid responsiveness in ICU patients: a critical analysis of the evidence // Chest. – 2000. – Vol. 121. – P. 200–208.
  • 26. Monge Garcia M. I., Gil Cano A., Gracia Romero M. Dynamic arterial elastance to predict arterial pressure response to volume loading in preload-dependent patients // Crit. Care. – 2011. – Vol. 15. – P. 15.
  • 27. Monge Garcia M. I., Gil Cano A., Gracia Romero M. et al. Non-invasive assessment of fluid responsiveness by changes in partial end-tidal CO2 pressure during a passive leg-raising maneuver // Ann. Intens. Care. – 2012. – Vol. 2. – P. 9.
  • 28. Monnet X., Bataille A., Magalhaes E. et al. End-tidal carbon dioxide is better than arterial pressure for predicting volume responsiveness by the passive leg raising test // Intens. Care Med. – 2013. – Vol. 39. – P. 93–100.
  • 29. Monge Garcia M. I., Romero M. G. et al. Dynamic arterial elastance as a predictor of arterial pressure response to fluid administration: a validation study // Crit. Care. – 2014. – Vol. 18. – P. 1–11.
  • 30. Monge Garcia M. I., Guijo González P., Gracia Romero M. et al. Effects of fluid administration on arterial load in septic shock patients // Intens. Care Med. – 2015. – Vol. 41. – P. 1247–1255.
  • 31. Monnet X., Rienzo M., Osman D. et al. Passive leg raising predicts fluid responsiveness in the critically ill // Crit. Care Med. – 2006. – Vol. 34. – P. 1402–1407.
  • 32. Monnet X., Jabot J., Teboul J. L. et al. Passive leg raising for predicting fluid responsiveness: importance of the postural change // Intens. Care Med. – 2009. –Vol. 35. – P. 85–90.
  • 33. Monnet X., Osman D., Ridel C. et al. Predicting volume responsiveness by using the end-expiratory occlusion in mechanically ventilated intensive care unit patients // Crit. Care Med. – 2009. – Vol. 37. – P. 951–956.
  • 34. Monnet X., Bleibtreu A., Ferré A. et al. Passive leg-raising and end–expiratory occlusion tests perform better than pulse pressure variation in patients with low respiratory system compliance // Crit. Care Med. – 2012. – Vol. 40. – P. 152–157.
  • 35. Monnet X., Teboul J. L. Assessment of volume responsiveness during mechanical ventilation: recent advances // Crit. Care. – 2013. – Vol. 17. – P. 217.
  • 36. Monnet X., Marik P. E., Teboul J. L. Prediction of fluid responsiveness: an update// Ann. Intens. Care. – 2016. – Vol. 6. – P. 111.
  • 37. Muller L., Toumi M., Bousquet P-J. et al. An increase in aortic blood flow after an infusion of 100 ml colloid over 1 min can predict fluid responsiveness // Anesthesiology. – 2011. – Vol. 115. – P. 541–547.
  • 38. Myatra S. N., Monnet X., Teboul J. L. Use of "tidal volume challenge" to improve the reliability of pulse pressure variation // Crit. Care. – 2017. – Vol. 21. – P. 5–6.
  • 39. Ornstein E., Eidelman L. A., Drenger B. et al. Systolic pressure variation predicts the response to acute blood loss // J. Clin. Anesth. – 1998. – Vol. 10. – P. 137–140.
  • 40. Osman D., Ridel C., Ray P. et al. Cardiac filling pressures are not appropriate to predict hemodynamic response to volume challenge // Crit. Care Med. – 2007. – Vol. 35. – P. 64–68.
  • 41. Patterson S. W., Starling E. H. On the mechanical factors which determine the output of the ventricles // J. Physiol. – 1994. – Vol. 48. – P. 357–379.
  • 42. Perel A., Pizov R., Cotev S. Systolic blood pressure variation is a sensitive indicator of hypovolemia in ventilated dogs subjected to graded hemorrhage // Anesthesiology. – 1987. – Vol. 67. – P. 498–502.
  • 43. Preisman S., DiSegni E., Vered Z. et al. Left ventricular preload and function during graded haemorrhage and retranfusion in pigs: analysis of arterial pressure waveform and correlation with echocardiography // Br. J. Anaesth. – 2002. – Vol. 88. – P. 716–718.
  • 44. Preisman S., Kogan S., Berkenstadt H. et al. Predicting fluid responsiveness in patients undergoing cardiac surgery: functional haemodynamic parameters including the Respiratory Systolic Variation Test and static preload indicators // Br J Anaesth. – 2005. – Vol. 95. – P. 746–755.
  • 45. Rex S., Brose S., Metzelder S. et al. Prediction of fluid responsiveness in patients duringcardiac surgery // Br. J. Anaesth. – 2004. – Vol. 93. – P. 782–788.
  • 46. Silva S., Jozwiak M., Teboul J.-L. et al. End-expiratory occlusion test predicts preload responsiveness independently of positive end-expiratory pressure during acute respiratory distress syndrome // Crit. Care Med. – 2013. – Vol. 41. – P. 1692–1701.
  • 47. Sirvent J.-M., Ferri C., Baro A. et al. Fluid balance in sepsis and septic shock as a determining factor of mortality // Am. J. Emerg. Med. – 2015. – Vol. 33. – P. 186–189.
  • 48. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016 // Crit. Care. – 2017. – Vol. 45. – P. 486–552.
  • 49. Tavernier B., Makhotine O., Lebuffe G. et al. Systolic pressure variation as a guide to fluid therapy in patients with sepsisinduced hypotension // Anesthesiology. – 1998. – Vol. 89. – P. 13–21.
  • 50. Wiesenack C., Fiegl C., Keyser A. et al. Continuously assessed right ventricular end-diastolic volume as a marker of cardiac preload and fluid responsiveness in mechanically ventilated cardiac surgical patients // Crit. Care. – 2005. – Vol. 9. – P. 226–233.
  • 51. Yang X., Du B. Does pulse pressure variation predict fluid responsiveness in critically ill patients? A systematic review and meta-analysis // Crit. Care. – 2014. – Vol. 18. – P. 1–13.
  • 52. Zhang Z., Lu B., Sheng X. et al. Accuracy of stroke volume variation in predicting fluid responsiveness: a systematic review and meta-analysis // J. Anesth. – 2011. – Vol. 25. – P. 904–916.
  • 53. Zhang L., Chen Z., Diao Y. et al. Associations of fluid overload with mortality and kidney recovery in patients with acute kidney injury: a systematic review and meta-analysis // J. Crit. Care. – 2015. – Vol. 30. – P. 860.

Для цитирования: Ильина Я. Ю., Кузьков В. В., Фот Е. В., Смёткин А. А., Киров М. Ю. Прогнозирование ответа на инфузионную нагрузку: современные подходы и перспективы «Вестник анестезиологии и реаниматологии» 2017; 14(3):0.DOI : 10.21292/2078-5658-2017-14-3-25-34


Для цитирования: Ильина Я. Ю., Кузьков В. В., Фот Е. В., Смёткин А. А., Киров М. Ю. Прогнозирование ответа на инфузионную нагрузку: современные подходы и перспективы «Вестник анестезиологии и реаниматологии» 2017; 14(3):0.DOI : 10.21292/2078-5658-2017-14-3-25-34

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