Intensive Care Unit, Department of Anaesthesiology, Pharmacology and Intensive Care, University Hospitals of Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211 Geneva 14, Switzerland ; Faculty of Medicine, University of Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211 Geneva 14, Switzerland.
Intensive Care Unit, Department of Anaesthesiology, Pharmacology and Intensive Care, University Hospitals of Geneva, 4 Rue Gabrielle-Perret-Gentil, 1211 Geneva 14, Switzerland.
Biomed Res Int. 2014;2014:129593. doi: 10.1155/2014/129593. Epub 2014 Apr 22.
The aim of this survey was to describe, in a situation of growing availability of monitoring devices and parameters, the practices in haemodynamic monitoring at the bedside.
We conducted a Web-based survey in Swiss adult ICUs (2009-2010). The questionnaire explored the kind of monitoring used and how the fluid management was addressed.
Our survey included 71% of Swiss ICUs. Echocardiography (95%), pulmonary artery catheter (PAC: 85%), and transpulmonary thermodilution (TPTD) (82%) were the most commonly used. TPTD and PAC were frequently both available, although TPTD was the preferred technique. Echocardiography was widely available (95%) but seems to be rarely performed by intensivists themselves. Guidelines for the management of fluid infusion were available in 45% of ICUs. For the prediction of fluid responsiveness, intensivists rely preferentially on dynamic indices or echocardiographic parameters, but static parameters, such as central venous pressure or pulmonary artery occlusion pressure, were still used.
In most Swiss ICUs, multiple haemodynamic monitoring devices are available, although TPTD is most commonly used. Despite the usefulness of echocardiography and its large availability, it is not widely performed by Swiss intensivists themselves. Regarding fluid management, several parameters are used without a clear consensus for the optimal method.
本调查旨在描述在监测设备和参数日益普及的情况下，床边进行血流动力学监测的实际情况。
我们于 2009 年至 2010 年在瑞士成人 ICU 中开展了一项基于网络的调查。问卷探讨了使用的监测类型以及如何解决液体管理问题。
我们的调查包括了瑞士 71%的 ICU。最常使用的是超声心动图（95%）、肺动脉导管（PAC：85%）和经肺温度稀释（TPTD）（82%）。TPTD 和 PAC 通常都可以获得，尽管 TPTD 是首选技术。超声心动图广泛应用（95%），但似乎很少由重症监护医生自己操作。45%的 ICU 有液体输注管理指南。对于预测液体反应性，重症监护医生更倾向于使用动态指数或超声心动图参数，但仍在使用中心静脉压或肺动脉闭塞压等静态参数。
在大多数瑞士 ICU 中，尽管 TPTD 最常用，但有多种血流动力学监测设备可供使用。尽管超声心动图具有很大的实用性且应用广泛，但瑞士重症监护医生自己很少进行操作。关于液体管理，使用了多个参数，但对于最佳方法尚无明确共识。
