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静脉血氧测定法的价值。

The value of venous oximetry.

作者信息

Reinhart Konrad, Bloos Frank

机构信息

Klinik f. Anästhesiologie und Intensivtherapie, Klinikum der Friedrich-Schiller-Universität, Jena, Germany.

出版信息

Curr Opin Crit Care. 2005 Jun;11(3):259-63. doi: 10.1097/01.ccx.0000158092.64795.cf.

Abstract

PURPOSE OF REVIEW

Maintenance of adequate tissue oxygenation is an important task in intensive care units. In this context, venous oximetry by obtaining mixed venous oxygen saturation or central venous oxygen saturation has been discussed as useful monitoring parameters. This review discusses the physiology and clinical application of these parameters.

RECENT FINDINGS

No study has so far demonstrated that venous oxygen saturation monitoring can reduce mortality in critically ill patients although length of stay has been decreased in cardiac surgery patients. Furthermore, pulmonary artery catheter usage does not affect outcome in critically ill patients. In contrast, early goal directed therapy for patients with severe sepsis or septic shock, which includes treatment goals for mean arterial pressure, central venous pressure, and central venous oxygen saturation, was able to increase survival in these patients. There is also evidence that central venous oxygen saturation measurement is beneficial in other types of shock.

SUMMARY

Early goal directed therapy should be implemented in the initial resuscitation of septic patients. Measurement of central venous oxygen saturation can easily be applied in intensive care unit patients and offers a useful indirect indicator for the adequacy of tissue oxygenation.

摘要

综述目的

维持充足的组织氧合是重症监护病房的一项重要任务。在此背景下,通过获取混合静脉血氧饱和度或中心静脉血氧饱和度进行静脉血氧测定已被视为有用的监测参数。本综述讨论了这些参数的生理学及临床应用。

最新发现

尽管心脏手术患者的住院时间有所缩短,但目前尚无研究表明静脉血氧饱和度监测可降低重症患者的死亡率。此外,肺动脉导管的使用并不影响重症患者的预后。相比之下,针对严重脓毒症或脓毒性休克患者的早期目标导向治疗,包括对平均动脉压、中心静脉压和中心静脉血氧饱和度的治疗目标,能够提高这些患者的生存率。也有证据表明中心静脉血氧饱和度测量对其他类型的休克有益。

总结

在脓毒症患者的初始复苏中应实施早期目标导向治疗。中心静脉血氧饱和度的测量可轻松应用于重症监护病房患者,并为组织氧合是否充足提供有用的间接指标。

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