Sattin Michael, Burhani Zain, Jaidka Atul, Millington Scott J, Arntfield Robert T
University of Western Ontario, London, ON, Canada.
University of Western Ontario, London, ON, Canada.
Chest. 2022 Jun;161(6):1598-1605. doi: 10.1016/j.chest.2022.01.022. Epub 2022 Jan 24.
Basic critical care echocardiography emphasizes two-dimensional (2D) findings, such as ventricular function, inferior vena cava size, and pericardial assessment, while generally excluding quantitative findings and Doppler-based techniques. Although this approach offers advantages, including efficiency and expedited training, it complicates attempts to understand the hemodynamic importance of any 2D abnormalities detected. Stroke volume (SV), as the summative event of the cardiac cycle, is the most pragmatic available indicator through which a clinician can rapidly determine, no matter the 2D findings, whether aberrant cardiac physiology is contributing to the state of shock. An estimate of SV allows 2D findings to be placed into better context in terms of both hemodynamic significance and acuity. This article describes the technique of SV determination, reviews common confounding factors and pitfalls, and suggests a systematic approach for using SV measurements to help integrate important 2D findings into the clinical context.
基础重症超声心动图强调二维（2D）检查结果，如心室功能、下腔静脉大小和心包评估，而通常不包括定量检查结果和基于多普勒的技术。尽管这种方法具有一些优点，包括效率高和培训速度快，但它使理解所检测到的任何二维异常的血流动力学重要性变得复杂。每搏输出量（SV）作为心动周期的总和事件，是临床医生可以快速确定的最实用的指标，无论二维检查结果如何，异常的心脏生理是否导致休克状态。SV的估计值可以使二维检查结果在血流动力学意义和严重程度方面更好地结合起来。本文描述了SV测定技术，回顾了常见的混杂因素和陷阱，并提出了一种系统的方法，用于使用SV测量值来帮助将重要的二维检查结果整合到临床情况中。
