Phillips R A, Smith B E, Madigan V M
Ultrasound and Cardiovascular Monitoring, Critical Care Research Group, School of Medicine, The University of Queensland, Brisbane, Australia.
Discipline of Intensive Care, University of Notre Dame Australia, Sydney, Australia.
Curr Anesthesiol Rep. 2017;7(4):387-398. doi: 10.1007/s40140-017-0235-4. Epub 2017 Nov 13.
Adequate oxygen delivery is essential for life, with hypoxia resulting in dysfunction, and ultimately death, of the cells, organs and organism. Blood flow delivers the oxygen bound in the blood, while haemodynamics is the science of blood flow. Stroke volume (SV) is the fundamental unit of blood flow, and reflects the interdependent performance of the heart, the vessels and the autonomic nervous system. However, haemodynamic management remains generally poor and predominantly guided by simple blood pressure observations alone.
Doppler ultrasound measures SV with unequalled clinical precision when operated by trained personnel. Combining SV with BP measurements allows calculation of flow-pressure based measures which better reflect cardiovascular performance and allows personalised physiologic and pathophysiologic modelling consistent with Frank's and Starling's observations.
Doppler SV monitoring and novel flow-pressure parameters may improve our understanding of the cardiovascular system and lead to improved diagnosis and therapy. This review examines the physics and practice of Doppler SV monitoring and its application in advanced haemodynamics.
充足的氧输送对生命至关重要，缺氧会导致细胞、器官和机体功能障碍，最终死亡。血流输送血液中结合的氧气，而血流动力学是研究血流的科学。每搏输出量（SV）是血流的基本单位，反映了心脏、血管和自主神经系统相互依存的功能。然而，血流动力学管理总体上仍然较差，主要仅由简单的血压观察来指导。
经训练的人员操作时，多普勒超声测量每搏输出量具有无与伦比的临床精度。将每搏输出量与血压测量相结合，可以计算基于流量-压力的指标，这些指标能更好地反映心血管功能，并允许进行与弗兰克和斯塔林观察结果一致的个性化生理和病理生理建模。
多普勒每搏输出量监测和新的流量-压力参数可能会增进我们对心血管系统的理解，并改善诊断和治疗。本综述探讨了多普勒每搏输出量监测的物理原理和实践及其在高级血流动力学中的应用。
