Lamia Bouchra, Chemla Denis, Richard Christian, Teboul Jean-Louis
Service de Réanimation Médicale, Centre Hospitalier Universitaire de Bicêtre, Assistance Publique-Hôpitaux de Paris, Université Paris Sud 11, Le Kremlin-Bicêtre, France.
Crit Care. 2005;9(6):601-6. doi: 10.1186/cc3891. Epub 2005 Oct 26.
In critically ill patients monitored with an arterial catheter, the arterial pressure signal provides two types of information that may help the clinician to interpret haemodynamic status better: the mean values of systolic, diastolic, mean and pulse pressures; and the magnitude of the respiratory variation in arterial pressure in patients undergoing mechanical ventilation. In this review we briefly discuss the physiological mechanisms responsible for arterial pressure generation, with special focus on resistance, compliance and pulse wave amplification phenomena. We also emphasize the utility of taking into consideration the overall arterial pressure set (systolic, diastolic, mean and pulse pressures) in order to define haemodynamic status better. Finally, we review recent studies showing that quantification of respiratory variation in pulse and systolic arterial pressures can allow one to identify the mechanically ventilated patients who may benefit from volume resuscitation.
在通过动脉导管进行监测的重症患者中，动脉压力信号提供了两类有助于临床医生更好地解读血流动力学状态的信息：收缩压、舒张压、平均压和脉压的平均值；以及接受机械通气患者的动脉压力呼吸变化幅度。在本综述中，我们简要讨论了动脉压力产生的生理机制，特别关注阻力、顺应性和脉搏波放大现象。我们还强调了考虑动脉压力总体情况（收缩压、舒张压、平均压和脉压）以更好地定义血流动力学状态的实用性。最后，我们回顾了近期的研究，这些研究表明，对脉搏和收缩期动脉压力的呼吸变化进行量化，可以帮助识别可能从容量复苏中获益的机械通气患者。
