颈动脉校正血流时间与颈动脉峰值流速变异度评估胃肠道肿瘤患者麻醉诱导前容量反应性OACSTPCD

Objective:To evaluate the accuracy of carotid corrected flow time(FTc)and respirophasic variation in carotid artery blood flow peak velocity(∆Vpeak-CA)in predicting gastrointestinal cancer patients'fluid responsiveness before anesthesia induc-tion.Methods:61 patients,24 males and 37 females,aged 18～65,with BMI of 18～30 kg/m2 and ASA physical status Ⅰ to Ⅱ,scheduled for elective gastrointestinal cancer surgery with general anesthesia from July 2019 to November 2021,were enrolled in the study.Volume load test(intravenous infusion of com-pound sodium chloride solution 10 mL/kg,which was completed at a uniform speed within 25～30 min)was performed in all pa-tients before anesthesia induction.Fluid responsiveness was defined as the 10％or more increase in stroke volume(∆SV)after the fluid challenge,which serves as a benchmark for assigning 21 patients to the non-responder group and 40 patients to the responder group.Heart rate,mean arterial pressure,carotid systolic flow time,cycle time,ejection fraction,stroke volume,maximum ca-rotid artery blood flow peak velocity and minimum carotid artery blood flow peak velocity were recorded 5 min before and 5 min after volume load test.The receiver operating characteristic(ROC)curve of carotid FTc and ∆Vpeak-CA predicting fluid responsiveness before anesthesia induction in patients with gastrointestinal cancer was plotted.Results:Carotid FTc was negatively correlated to∆SV(r =-0.67,P<0.001).The area under the curve of carotid FTc predicting fluid responsiveness was 0.774,with the sensi-tivity and specificity of 80％and 71.4％.∆Vpeak-CA was positive correlated to ∆SV(r = 0.425,P<0.001).The area under the curve of ∆Vpeak-CA predicting fluid responsiveness was 0.768,with the sensitivity and specificity of 77.5％and 61.9％.Con-clusion:Both carotid FTc and ∆Vpeak-CA are valuable in predicting fluid responsiveness before anesthesia induction in patients undergoing gastrointestinal surgery.