Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070, Brussels, Belgium.
Crit Care. 2018 Mar 22;22(1):81. doi: 10.1186/s13054-018-1962-8.
The importance of personalized blood pressure management is well recognized. Because renal pressure-flow relationships may vary among patients, understanding how renal autoregulation may influence blood pressure control is essential. However, much remains uncertain regarding the determinants of renal autoregulation in circulatory shock, including the influence of comorbidities and the effects of vasopressor treatment. We review published studies on renal autoregulation relevant to the management of acutely ill patients with shock. We delineate the main signaling pathways of renal autoregulation, discuss how it can be assessed, and describe the renal autoregulatory alterations associated with chronic disease and with shock.
个性化血压管理的重要性已得到广泛认可。由于患者之间的肾压力-流量关系可能存在差异，因此了解肾自动调节如何影响血压控制至关重要。然而，关于循环休克中肾自动调节的决定因素，包括合并症的影响和血管加压素治疗的影响，仍有许多不确定之处。我们回顾了与休克急性病患者管理相关的肾自动调节的已发表研究。我们描述了肾自动调节的主要信号通路，讨论了如何评估肾自动调节，并描述了与慢性疾病和休克相关的肾自动调节改变。
