Yamada Takashige, Vacas Susana, Gricourt Yann, Cannesson Maxime
Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles, Los Angeles, CA, United States.
Department of Anesthesiology, Keio University School of Medicine, Tokyo, Japan.
Front Med (Lausanne). 2018 May 17;5:144. doi: 10.3389/fmed.2018.00144. eCollection 2018.
An increasing number of patients require precise intraoperative hemodynamic monitoring due to aging and comorbidities. To prevent undesirable outcomes from intraoperative hypotension or hypoperfusion, appropriate threshold settings are required. These setting can vary widely from patient to patient. Goal-directed therapy techniques allow for flow monitoring as the standard for perioperative fluid management. Based on the concept of personalized medicine, individual assessment and treatment are more advantageous than conventional or uniform interventions. The recent development of minimally and noninvasive monitoring devices make it possible to apply detailed control, tracking, and observation of broad patient populations, all while reducing adverse complications. In this manuscript, we review the monitoring features of each device, together with possible advantages and disadvantages of their use in optimizing patient hemodynamic management.
由于老龄化和合并症,越来越多的患者需要精确的术中血流动力学监测。为防止术中低血压或低灌注导致不良后果,需要设置合适的阈值。这些设置在患者之间可能有很大差异。目标导向治疗技术将血流监测作为围手术期液体管理的标准。基于个性化医疗的概念,个体评估和治疗比传统的或统一的干预更具优势。微创和无创监测设备的最新发展使得对广泛患者群体进行详细控制、跟踪和观察成为可能,同时减少不良并发症。在本手稿中,我们回顾了每种设备的监测特点,以及它们在优化患者血流动力学管理中的可能优缺点。