Rady M Y
Department of Emergency Medicine, Henry Ford Hospital, Detroit, MI 48202.
Resuscitation. 1992 Aug-Sep;24(1):55-60. doi: 10.1016/0300-9572(92)90173-a.
Initial therapy of shock in the emergency department emphasizes the normalization of hemodynamic variables e.g. heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP) rather than optimization of systemic and regional oxygenation. Central venous oximetry (ScvO2), arterial lactic acid concentrations (Lact) and the shock index (SI) were examined during initial hemodynamic stabilization of clinical shock in the emergency room. Although initial therapy normalized MAP, CVP and HR; ScvO2, Lact and SI continued to be abnormal indicating inadequate systemic oxygenation and left ventricular (LV) performance. Measurement of ScvO2, Lact and SI may provide valuable additional information on the adequacy of systemic oxygenation and LV function during initial therapy of shock. This may identify patients who require further monitoring and intervention to optimize systemic oxygen transport and cardiac performance and reduce their morbidity and mortality.
急诊科对休克的初始治疗强调血流动力学变量（如心率（HR）、平均动脉压（MAP）、中心静脉压（CVP））的正常化，而非全身和局部氧合的优化。在急诊室对临床休克进行初始血流动力学稳定治疗期间，检测了中心静脉血氧饱和度（ScvO2）、动脉血乳酸浓度（Lact）和休克指数（SI）。尽管初始治疗使MAP、CVP和HR恢复正常，但ScvO2、Lact和SI仍异常，表明全身氧合不足和左心室（LV）功能欠佳。在休克初始治疗期间，检测ScvO2、Lact和SI可能会为全身氧合是否充足及LV功能提供有价值的额外信息。这可能识别出需要进一步监测和干预以优化全身氧输送和心脏功能并降低其发病率和死亡率的患者。
