본문 바로가기
HOME> 논문 > 논문 검색상세

학위논문 상세정보

간이식 수술 중 비침습적인 동적 혈역학 변수로서 심음에서 측정한 심실 수축 시간의 수액 투여 반응에 대한 예측 : Prediction of Fluid Responsiveness by a Non-invasive Beat-to-beat Assessment of Ventricular Systolic Time using Heart Sound Signal during Liver Transplantation 원문보기

  • 저자

    김성훈

  • 학위수여기관

    울산대학교

  • 학위구분

    국내박사

  • 학과

    의학과 마취통증의학

  • 지도교수

    황규삼

  • 발행년도

    2014

  • 총페이지

  • 키워드

    Dynamic index+fluid responsiveness+heart sound+liver transplantation+phonocardiogram+ventricular systolic time;

  • 언어

    eng

  • 원문 URL

    http://www.riss.kr/link?id=T13540295&outLink=K  

  • 초록

    BACKGROUND: The fluid management of cirrhotic patients undergoing liver transplantation is challenging. As a graphic recording of heart sound, phonocardiography, provides valuable information concerning the function and hemodynamic condition of the heart, it has a high potential for clinical monitoring device. The purpose of this study was to compare ventricular systolic time (VST, the interval between the first and second heart sound) with the corresponding beat-to-beat hemodynamic data and to assess whether VST could predict fluid responsiveness in cirrhotic patient undergoing liver transplantation. METHODS: Thirty liver transplantation recipients who needed volume expansion during surgery were included. The fluid challenge was standardized and consisted of 500 ml of 5% albumin administered over 10 min during the saphenous vein harvest period of pre-anhepatic phase. Beat-to-beat hemodynamic parameters and heart sound signal were collected during study protocol. VST was measured as the time interval between maximal amplitude of each heart sounds using the Hilbert transformation, and the respiratory variation of VST (VSTV) induced by mechanical ventilation was calculated. Responders were defined as a ≥10% increase in stroke volume index after volume expansion. RESULTS: Fourteen patients (46.7%) of the 30 patients were responders. Beat-to-beat VST values were closely correlated with their corresponding pulse pressure values (r = 0.77). The responders showed significant increases in VST (283.8 ± 40.4 ms vs 297.0 ± 40.3 ms, P


 활용도 분석

  • 상세보기

    amChart 영역
  • 원문보기

    amChart 영역