Saugel Bernd, Dueck Ron, Wagner Julia Y
Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
Anesthesiology Service, Veterans Affairs San Diego Healthcare System, San Diego, CA 92161-5085, USA; Department of Anesthesiology, University of California, 3350 La Jolla Village Dr, San Diego, CA 92161-5085, USA.
Best Pract Res Clin Anaesthesiol. 2014 Dec;28(4):309-22. doi: 10.1016/j.bpa.2014.08.001. Epub 2014 Sep 6.
Blood pressure is overwhelmingly the most commonly measured parameter for the assessment of haemodynamic stability. In clinical routine in the operating theatre and in the intensive care unit, blood pressure measurements are usually obtained intermittently and non-invasively using oscillometry (upper-arm cuff method) or continuously and invasively with an arterial catheter. However, both the oscillometric method and arterial catheter-derived blood pressure measurements have potential limitations. A basic technical understanding of these methods is crucial in order to avoid unreliable blood pressure measurements and consequential treatment errors. In the recent years, technologies for continuous non-invasive blood pressure recording such as the volume clamp method or radial artery applanation tonometry have been developed and validated. The question in which patient groups and clinical settings these technologies should be applied to improve patient safety or outcome has not been definitively answered. In critically ill patients and high-risk surgery patients, further improvement of these technologies is needed before they can be recommended for routine clinical use.
血压无疑是评估血流动力学稳定性时最常测量的参数。在手术室和重症监护病房的临床常规操作中,血压测量通常使用示波法(上臂袖带法)间歇性、非侵入性地进行,或者通过动脉导管连续、侵入性地获取。然而,示波法和动脉导管衍生的血压测量都有潜在的局限性。对这些方法有基本的技术理解对于避免不可靠的血压测量及后续治疗错误至关重要。近年来,诸如容积钳法或桡动脉压平式测压法等连续无创血压记录技术已经得到开发和验证。这些技术应应用于哪些患者群体和临床环境以提高患者安全性或改善治疗结果的问题尚未得到明确解答。在危重症患者和高风险手术患者中,这些技术在被推荐用于常规临床使用之前还需要进一步改进。