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危重症患者的血流动力学监测:当前心输出量监测方法概述

Hemodynamic monitoring in the critically ill: an overview of current cardiac output monitoring methods.

作者信息

Huygh Johan, Peeters Yannick, Bernards Jelle, Malbrain Manu L N G

机构信息

ZNA Stuivenberg, Lange Beeldekensstraat 267, B-2060 Antwerpen, Belgium.

出版信息

F1000Res. 2016 Dec 16;5. doi: 10.12688/f1000research.8991.1. eCollection 2016.

Abstract

Critically ill patients are often hemodynamically unstable (or at risk of becoming unstable) owing to hypovolemia, cardiac dysfunction, or alterations of vasomotor function, leading to organ dysfunction, deterioration into multi-organ failure, and eventually death. With hemodynamic monitoring, we aim to guide our medical management so as to prevent or treat organ failure and improve the outcomes of our patients. Therapeutic measures may include fluid resuscitation, vasopressors, or inotropic agents. Both resuscitation and de-resuscitation phases can be guided using hemodynamic monitoring. This monitoring itself includes several different techniques, each with its own advantages and disadvantages, and may range from invasive to less- and even non-invasive techniques, calibrated or non-calibrated. This article will discuss the indications and basics of monitoring, further elaborating on the different techniques of monitoring.

摘要

重症患者常因血容量不足、心功能不全或血管舒缩功能改变而出现血流动力学不稳定(或有不稳定风险),进而导致器官功能障碍、恶化为多器官功能衰竭,最终死亡。通过血流动力学监测,我们旨在指导医疗管理,以预防或治疗器官衰竭并改善患者预后。治疗措施可能包括液体复苏、血管加压药或正性肌力药物。复苏阶段和减复苏阶段均可通过血流动力学监测来指导。这种监测本身包括几种不同技术,每种技术都有其优缺点,范围从侵入性到低侵入性甚至非侵入性技术,有校准的或未校准的。本文将讨论监测的适应证和基础知识,并进一步阐述不同的监测技术。

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