Dias Fernando Suparregui, Rezende Ederlon, Mendes Ciro Leite, Réa-Neto Alvaro, David Cid Marcos, Schettino Guilherme, Lobo Suzana Margareth Ajeje, Barros Alberto, Silva Eliézer, Friedman Gilberto, Amaral José Luiz Gomes do, Park Marcelo, Monachini Maristela, Oliveira Mirella Cristine de, Assunção Murillo Santucci César, Akamine Nelson, Mello Patrícia Veiga C, Pereira Renata Andréa Pietro, Costa Filho Rubens, Araújo Sebastião, Félix Pinto Sérgio, Ferreira Sérgio, Mitushima Simone Mattoso, Agareno Sydney, Brilhante Yuzeth Nóbrega de Assis
Associação de Medicina Intensiva Brasileira.
Rev Bras Ter Intensiva. 2006 Mar;18(1):63-77.
Monitoring of vital functions is one of the most important tools in the management of critically ill patients. Nowadays is possible to detect and analyze a great deal of physiologic data using a lot of invasive and non-invasive methods. The intensivist must be able to select and carry out the most appropriate monitoring technique according to the patient requirements and taking into account the benefit/risk ratio. Despite the fast development of non invasive monitoring techniques, invasive hemodynamic monitoring using Pulmonary Artery Catheter still is one of the basic procedures in Critical Care. The aim was to define recommendations about clinical utility of basic hemodynamic monitoring methods and the Use of Pulmonary Artery Catheter.
Modified Delphi methodology was used to create and quantify the consensus between the participants. AMIB indicated a coordinator who invited more six experts in the area of monitoring and hemodynamic support to constitute the Consensus Advisory Board. Twenty-five physicians and nurses selected from different regions of the country completed the expert panel, which reviewed the pertinent bibliography listed at the MEDLINE in the period from 1996 to 2004.
Recommendations were made based on 55 questions about the use of central venous pressure, invasive arterial pressure, pulmonary artery catheter and its indications in different settings.
Evaluation of central venous pressure and invasive arterial pressure, besides variables obtained by the PAC allow the understanding of cardiovascular physiology that is of great value to the care of critically ill patients. However, the correct use of these tools is fundamental to achieve the benefits due to its use.
对危重症患者进行生命功能监测是最重要的管理手段之一。如今，利用多种有创和无创方法能够检测和分析大量生理数据。重症监护医生必须能够根据患者需求并考虑效益/风险比，选择并实施最合适的监测技术。尽管无创监测技术发展迅速，但使用肺动脉导管进行有创血流动力学监测仍是重症监护中的基本操作之一。本研究旨在明确关于基本血流动力学监测方法及肺动脉导管应用的临床实用性建议。
采用改良德尔菲法在参与者之间达成共识并进行量化。AMIB指定了一名协调员，邀请了另外六位监测与血流动力学支持领域的专家组成共识咨询委员会。从该国不同地区挑选出的25名医生和护士组成专家小组，他们查阅了1996年至2004年期间MEDLINE上列出的相关文献。
基于55个关于中心静脉压、有创动脉压、肺动脉导管及其在不同情况下的适应证的问题提出了建议。
对中心静脉压和有创动脉压的评估，以及肺动脉导管获取的变量，有助于理解心血管生理学，这对危重症患者的护理具有重要价值。然而，正确使用这些工具对于实现其使用效益至关重要。
