Villazón S A, Sierra U A, López S F, Rolando M A
Crit Care Med. 1975 Nov-Dec;3(6):215-21. doi: 10.1097/00003246-197511000-00002.
Nine variables were studied in 56 patients to analyze hemodynamic patterns of critically ill and shock patients. The variables were central venous pressure, mean arterial pressure, heart rate, cardiac index, left ventricular stroke work, strok index, total peripheral resistance, arteriovenous oxygen difference, and oxygen consumption. We observed six patterns; three with low cardiac index (hypodynamic) and three with high cardiac index (hyperdynamic). Group IA: Low cardiac index with increased central venous pressure and arteriovenous oxygen differences associated with myocardial infarction, cardiac insufficiency, and postoperative cardiac surgery: Group IB: Low cardiac index with normal arteriovenous oxygen difference associated with myocardial infarction or hypovolemia. Group IC: Low cardiac index and decreased arteriovenous oxygen difference in patients with hypodynamic septic shock. Group IID: High cardiac index and increased arteriovenous oxygen difference in patients with sepsis and stable hemodynamic conditions. Groups IIE and IIF: Increased cardiac index and normal or increased arteriovenous oxygen difference in septic patients, who were hemodymamically unstable or in shock. These hemodynamic observations were found to be useful for understanding physiological compensations, for deciding on therapy, and in evaluating the effectiveness of therapy.
对56例患者的9项变量进行了研究，以分析危重症和休克患者的血流动力学模式。这些变量包括中心静脉压、平均动脉压、心率、心脏指数、左心室每搏功、每搏指数、总外周阻力、动静脉血氧差和氧耗量。我们观察到六种模式；三种为低心脏指数（低动力型），三种为高心脏指数（高动力型）。IA组：低心脏指数伴中心静脉压升高和动静脉血氧差增加，与心肌梗死、心功能不全及心脏术后有关；IB组：低心脏指数伴动静脉血氧差正常，与心肌梗死或血容量不足有关。IC组：低动力型感染性休克患者心脏指数低且动静脉血氧差降低。IID组：脓毒症且血流动力学稳定患者心脏指数高且动静脉血氧差增加。IIE组和IIF组：血流动力学不稳定或处于休克状态的脓毒症患者心脏指数增加且动静脉血氧差正常或增加。这些血流动力学观察结果被发现有助于理解生理代偿、决定治疗方案以及评估治疗效果。
