Elhassan Mohammed G, Chao Peter W, Curiel Argenis
Internal Medicine, Saint Agnes Medical Center, Fresno, USA.
Cureus. 2021 May 26;13(5):e15253. doi: 10.7759/cureus.15253.
Assessment of patients' volume status at the bedside is a very important clinical skill that physicians need in many clinical scenarios. Hypovolemia with hypotension and tissue under-perfusion are usually more alarming to physicians, but hypervolemia is also associated with poor outcomes, making euvolemia a crucial goal in clinical practice. Nevertheless, the assessment of volume status can be challenging, especially in the absence of a gold standard test that is reliable and easily accessible to assist with clinical decision-making. Physicians need to have a broad knowledge of the individual non-invasive clinical tools available for them at the bedside to evaluate volume status. In this review, we will discuss the strengths and limitations of the traditional tools, which include careful history taking, physical examination, and basic laboratory tests, and also include the relatively new tool of point-of-care ultrasound.
在床边评估患者的容量状态是一项非常重要的临床技能，医生在许多临床场景中都需要掌握。伴有低血压和组织灌注不足的低血容量通常更令医生担忧，但高血容量也与不良预后相关，这使得等容状态成为临床实践中的一个关键目标。然而，容量状态的评估可能具有挑战性，尤其是在缺乏可靠且易于获取的金标准检测来辅助临床决策的情况下。医生需要广泛了解床边可用的各种非侵入性临床工具，以便评估容量状态。在本综述中，我们将讨论传统工具的优缺点，这些传统工具包括仔细的病史采集、体格检查和基础实验室检查，还包括即时超声这一相对较新的工具。
