Beigel Roy, Cercek Bojan, Arsanjani Reza, Siegel Robert J
The Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA.
The Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA.
J Crit Care. 2014 Feb;29(1):184.e1-8. doi: 10.1016/j.jcrc.2013.09.003. Epub 2013 Oct 14.
Invasive pulmonary artery catheter measurements are the standard method for assessment of hemodynamic evaluation at the present time. However, this invasive approach is associated with an increase in patient morbidity and without evidence of a reduction in mortality. Doppler echocardiography is a noninvasive method that provides robust data regarding patients' hemodynamic indices. Several parameters are available for noninvasive hemodynamic evaluation using Doppler echocardiography. Most of these measurements are easily obtained and provide a safe alternative to invasive hemodynamic assessment. As Doppler echocardiography is able to provide additional valuable information, such as cardiac systolic and diastolic function, and the presence of pericardial and pleural effusions, which can play a significant role in the patients' hemodynamic status, using this noninvasive modality in the daily practice for hemodynamic assessment can prove an alternative to invasive measures in selected patients as well as a complementary tool for those still in need of invasive monitoring.
目前,有创肺动脉导管测量是评估血流动力学的标准方法。然而,这种有创方法会增加患者的发病率,且并无证据表明其能降低死亡率。多普勒超声心动图是一种无创方法,可提供有关患者血流动力学指标的可靠数据。使用多普勒超声心动图进行无创血流动力学评估有多个参数可供选择。这些测量大多易于获得,为有创血流动力学评估提供了一种安全的替代方法。由于多普勒超声心动图能够提供额外的有价值信息,如心脏的收缩和舒张功能,以及心包和胸腔积液的存在情况,而这些信息对患者的血流动力学状态可能起到重要作用,因此在日常实践中使用这种无创方式进行血流动力学评估,对于部分患者而言可替代有创测量方法,对于仍需有创监测的患者来说也是一种补充工具。