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确定危重症患者的复苏目标。

Defining goals of resuscitation in the critically ill patient.

作者信息

Joosten Alexandre, Alexander Brenton, Cannesson Maxime

机构信息

Department of Anesthesiology and Perioperative Care, University of California, Irvine, 101 The City Drive South, Orange, CA 92868, USA; Department of Anesthesiology and Critical Care, Erasme University Hospital, Free University of Brussels, 808 Lennick Road, Brussels 1070, Belgium.

Department of Anesthesiology and Perioperative Care, University of California, Irvine, 101 The City Drive South, Orange, CA 92868, USA.

出版信息

Crit Care Clin. 2015 Jan;31(1):113-32. doi: 10.1016/j.ccc.2014.08.006.

Abstract

There is still no "universal" consensus on an optimal endpoint for goal directed therapy (GDT) in the critically ill patient. As in other areas of medicine, this should help providers to focus on a more "individualized approach" rather than a protocolized approach to ensure proper patient care. Hemodynamic optimization needs more than simply blood pressure, heart rate, central venous pressure and urine output monitoring. It is essential to also monitor flow variables (cardiac output/stroke volume) and dynamic parameters of fluid responsiveness whenever available. This article will provide a review of current and trending approaches of the goals of resuscitation in the critically ill patient.

摘要

对于危重症患者目标导向治疗(GDT)的最佳终点,目前仍未达成“普遍”共识。与医学的其他领域一样,这应有助于医护人员专注于更“个体化的方法”,而非遵循固定方案的方法,以确保对患者的恰当护理。血流动力学优化不仅仅需要监测血压、心率、中心静脉压和尿量。只要条件允许,监测血流变量(心输出量/每搏输出量)和液体反应性的动态参数也至关重要。本文将综述危重症患者复苏目标的当前及流行方法。

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