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血流动力学治疗中的微循环导向保护策略。

Microcirculation-guided protection strategy in hemodynamic therapy.

机构信息

Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.

Center of Respiratory and Critical Care Medicine, Chinese PLA General Hospital, Beijing, China.

出版信息

Clin Hemorheol Microcirc. 2020;75(2):243-253. doi: 10.3233/CH-190784.

Abstract

Microcirculatory shock is a condition defined by the presence of tissue hypoperfusion despite the normalization of systemic and regional blood flow. Currently, more evidence shows that intrinsic septic shock is microcirculatory shock, which results in septic shock that is difficult to resuscitate. At present, treatments are aimed at recovering macro-circulation functions and include fluid resuscitation, vasoactive drugs, positive inotropic drugs, de-obstruction, and even mechanical assistance to improve oxygen delivery. However, the application of these treatments to more accurately improve microcirculation or avoid further microcirculatory damage is more important in clinics. In this article, we discuss the need for microcirculation protection and microcirculation-guided protection strategies in hemodynamic therapies.

摘要

微循环休克是一种定义为组织灌注不足的情况,尽管全身和区域性血流已经恢复正常。目前,更多的证据表明,内在的感染性休克就是微循环休克,这导致感染性休克难以复苏。目前,治疗方法旨在恢复宏观循环功能,包括液体复苏、血管活性药物、正性肌力药物、解除梗阻,甚至机械辅助以提高氧输送。然而,在临床上,这些治疗方法更重要的是应用于更准确地改善微循环或避免进一步的微循环损伤。在本文中,我们讨论了在血流动力学治疗中对微循环保护和微循环导向保护策略的需求。

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