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危重症心脏病患者容量超负荷的心外体征:使用床旁超声进行的重点评估

Extracardiac Signs of Fluid Overload in the Critically Ill Cardiac Patient: A Focused Evaluation Using Bedside Ultrasound.

作者信息

Beaubien-Souligny William, Bouchard Josée, Desjardins Georges, Lamarche Yoan, Liszkowski Mark, Robillard Pierre, Denault André

机构信息

Nephrology Department, Université de Montréal, Montreal, Québec, Canada.

Nephrology Department, Hôpital Sacré-Coeur de Montréal, Montreal, Québec, Canada.

出版信息

Can J Cardiol. 2017 Jan;33(1):88-100. doi: 10.1016/j.cjca.2016.08.012. Epub 2016 Aug 24.

Abstract

Fluid balance management is of great importance in the critically ill cardiac patient. Although intravenous fluids are a cornerstone therapy in the management of unstable patients, excessive administration coupled with cardiac dysfunction leads to elevation in central venous pressure and end-organ venous congestion. Fluid overload is known to have a detrimental effect on organ function and is responsible for significant morbidity in critically ill patients. Multisystem bedside point of care ultrasound imaging can be used to assess signs of fluid overload and venous congestion in critically ill patients. In this review we describe the ultrasonographic extracardiac signs of fluid overload and how they can be used to complement clinical evaluation to individualize patient management.

摘要

液体平衡管理在危重心脏病患者中至关重要。尽管静脉输液是不稳定患者管理中的基石性治疗方法,但过量输液加上心脏功能障碍会导致中心静脉压升高和终末器官静脉淤血。众所周知,液体过载对器官功能有不利影响,是危重症患者发病的重要原因。多系统床边即时超声成像可用于评估危重症患者的液体过载和静脉淤血迹象。在本综述中,我们描述了液体过载的心脏外超声征象,以及如何利用这些征象辅助临床评估,实现患者管理的个体化。

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