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每个人都能够且应该在重症监护病房进行心脏超声检查的十个充分理由。

Ten good reasons why everybody can and should perform cardiac ultrasound in the ICU.

作者信息

Charron Cyril, Repessé Xavier, Bodson Laurent, Au Siu-Ming, Vieillard-Baron Antoine

出版信息

Anaesthesiol Intensive Ther. 2014 Nov-Dec;46(5):319-22. doi: 10.5603/AIT.2014.0055.

Abstract

Critical care ultrasonography (CCUS) has been defined as an ultrasound evaluation of the heart, abdomen, pleura and lungs at the bedside by the intensivist, 24/7. Within CCUS, critical care echocardiography (CCE) is used to assess cardiac function and more generally haemodynamics. Experts in haemodynamics have published a 'consensus of 16' regarding an update on haemodynamic monitoring. They reported the ten key properties of an 'ideal' haemodynamic monitoring system, which perfectly match the ten good reasons we describe here for performing CCE in critically ill patients. Even though unfortunately no evidence-based medicine study is available to support this review, especially regarding CCE-related improvement of outcome, many clinical studies have demonstrated that CCE provides measurements of relevant, accurate, reproducible and interpretable variables, is easy to use, readily available, has a rapid response time, causes no harm, and is cost-effective. Whether it is operator-independent is obviously more debatable and is discussed in this review. All these characteristics are arguments for the extensive use of CCE by intensivists. This is why experts in the field have recommended that a basic level of CCE should be included in the training of all intensivists.

摘要

重症超声检查(CCUS)被定义为重症监护医生在床边随时对心脏、腹部、胸膜和肺部进行的超声评估。在CCUS中,重症超声心动图(CCE)用于评估心脏功能以及更广泛的血流动力学。血流动力学专家已发布了一份关于血流动力学监测更新的“16项共识”。他们报告了“理想”血流动力学监测系统的十个关键特性,这与我们在此描述的在危重症患者中进行CCE的十个充分理由完美匹配。尽管遗憾的是没有循证医学研究来支持本综述,特别是关于CCE对预后的改善,但许多临床研究表明,CCE可提供相关、准确、可重复且可解释的变量测量,易于使用,随时可用,响应时间快,无害且具有成本效益。它是否与操作者无关显然更具争议性,本综述对此进行了讨论。所有这些特性都是重症监护医生广泛使用CCE的依据。这就是该领域专家建议在所有重症监护医生的培训中纳入CCE基本水平内容的原因。

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