Shoemaker William C
Department of Anesthesia and Surgery, Los Angeles County and University of Southern California Medical Center, University of Southern California, 90033, USA.
Surg Clin North Am. 2002 Feb;82(1):245-55. doi: 10.1016/S0039-6109(03)00153-1.
The mathematical model satisfactorily predicted outcome in acute emergencies based on noninvasively monitored flow, pressure, pulse oximetry, tissue perfusion values, and their cumulative deficits. A decision support system provided information on the relative effectiveness of various therapeutic modalities based on the responses of patients with very similar states. The concept that hypovolemia and oxygen debt is an early primary problem that plays an important role in low flow and poor tissue perfusion states is supported by direct observation of massive hemorrhage, estimated blood loss of hemoperitoneum and hemothorax at the time of surgery, and prior studies in the literature that documented blood volume deficits in posttraumatic and postoperative patients who subsequently developed organ failures and death.
该数学模型基于非侵入性监测的血流、压力、脉搏血氧饱和度、组织灌注值及其累积不足，令人满意地预测了急性紧急情况的结果。决策支持系统根据状态非常相似的患者的反应，提供了各种治疗方式相对有效性的信息。低血容量和氧债是一个早期主要问题，在低血流和组织灌注不良状态中起重要作用，这一概念得到了以下方面的支持：对大量出血的直接观察、手术时腹腔积血和血胸的估计失血量，以及文献中先前的研究，这些研究记录了创伤后和术后随后发生器官衰竭和死亡的患者的血容量不足情况。
