再谈灌注指数。
Perfusion indices revisited.
作者信息
Hasanin Ahmed, Mukhtar Ahmed, Nassar Heba
机构信息
Anesthesia and Critical Care Medicine, Cairo University, Giza, Egypt.
Critical Care Department, El-Ameen Hospital, Taif, Kingdom of Saudi Arabia.
出版信息
J Intensive Care. 2017 Mar 14;5:24. doi: 10.1186/s40560-017-0220-5. eCollection 2017.
Abstract
Monitoring of tissue perfusion is an essential step in the management of acute circulatory failure. The presence of cellular dysfunction has been a basic component of shock definition even in the absence of hypotension. Monitoring of tissue perfusion includes biomarkers of global tissue perfusion and measures for assessment of perfusion in non-vital organs. The presence of poor tissue perfusion in a shocked patient is usually associated with worse outcome. Persistently impaired perfusion despite adequate resuscitation is also associated with worse outcome. Thus, normalization of some perfusion indices has become one of the resuscitation targets in patients with septic shock. Although the collective evidence shows the clear relation between impaired peripheral perfusion and mortality, the use of different perfusion indices as a resuscitation target needs more research.
摘要
监测组织灌注是急性循环衰竭管理中的关键步骤。即使在无低血压的情况下，细胞功能障碍的存在也是休克定义的基本组成部分。组织灌注监测包括整体组织灌注的生物标志物以及非重要器官灌注评估措施。休克患者存在组织灌注不良通常与更差的预后相关。尽管进行了充分复苏但灌注持续受损也与更差的预后相关。因此，使某些灌注指标恢复正常已成为脓毒症休克患者的复苏目标之一。虽然总体证据表明外周灌注受损与死亡率之间存在明确关联，但将不同的灌注指标用作复苏目标仍需更多研究。
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