Keller Marius, Magunia Harry, Rosenberger Peter, Koeppen Michael
Department of Anesthesiology and Intensive Care Medicine, University Hospital Tübingen, Hoppe-Seyler-Straße 3, 72076 Tübingen, Germany.
Diagnostics (Basel). 2023 Feb 22;13(5):839. doi: 10.3390/diagnostics13050839.
In critically ill patients, hemodynamic disturbances are common and often lead to a detrimental outcome. Frequently, invasive hemodynamic monitoring is required for patients who are hemodynamically unstable. Although the pulmonary artery catheter enables a comprehensive assessment of the hemodynamic profile, this technique carries a substantial inherent risk of complications. Other less invasive techniques do not offer a full range of results to guide detailed hemodynamic therapies. An alternative with a lower risk profile is transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE). After training, intensivists can obtain similar parameters on the hemodynamic profile using echocardiography, such as stroke volume and ejection fraction of the right and left ventricles, an estimate of the pulmonary artery wedge pressure, and cardiac output. Here, we will review individual echocardiography techniques that will help the intensivist obtain a comprehensive assessment of the hemodynamic profile using echocardiography.
在危重症患者中,血流动力学紊乱很常见,且常常导致不良后果。对于血流动力学不稳定的患者,通常需要进行有创血流动力学监测。尽管肺动脉导管能够全面评估血流动力学状况,但这项技术存在大量固有的并发症风险。其他侵入性较小的技术无法提供全面的结果来指导详细的血流动力学治疗。风险较低的替代方法是经胸超声心动图(TTE)或经食管超声心动图(TEE)。经过培训后,重症监护医生可以使用超声心动图获得类似的血流动力学参数,如左右心室的每搏输出量和射血分数、肺动脉楔压估计值以及心输出量。在此,我们将回顾各种超声心动图技术,这些技术将帮助重症监护医生使用超声心动图全面评估血流动力学状况。