Rinehart Joseph, Lee Sean, Saugel Bernd, Joosten Alexandre
Department of Anesthesiology and Perioperative Care, University of California Irvine, Orange, California.
Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Semin Respir Crit Care Med. 2021 Feb;42(1):47-58. doi: 10.1055/s-0040-1713083. Epub 2020 Aug 3.
Arterial pressure management is a crucial task in the operating room and intensive care unit. In high-risk surgical and in critically ill patients, sustained hypotension is managed with continuous infusion of vasopressor agents, which most commonly have direct α agonist activity like phenylephrine or norepinephrine. The current standard of care to guide vasopressor infusion is manual titration to an arterial pressure target range. This approach may be improved by using automated systems that titrate vasopressor infusions to maintain a target pressure. In this article, we review the evidence behind blood pressure management in the operating room and intensive care unit and discuss current and potential future applications of automated blood pressure control.
动脉血压管理是手术室和重症监护病房中的一项关键任务。在高风险手术患者和危重症患者中,持续性低血压通过持续输注血管升压药来处理,这些药物最常见的是具有直接α激动剂活性的药物,如去氧肾上腺素或去甲肾上腺素。目前指导血管升压药输注的护理标准是手动滴定至动脉压目标范围。通过使用自动系统滴定血管升压药输注以维持目标压力,这种方法可能会得到改进。在本文中,我们回顾了手术室和重症监护病房中血压管理背后的证据,并讨论了自动血压控制的当前及潜在未来应用。