Leeds Congenital Heart Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
Leeds Institute for Data Analytics, University of Leeds, Leeds, West Yorkshire, UK.
Arch Dis Child. 2023 Dec;108(12):949-955. doi: 10.1136/archdischild-2022-325030. Epub 2023 Mar 16.
Cardiac output monitoring enables physiology-directed management of critically ill children and aids in the early detection of clinical deterioration. Multiple invasive techniques have been developed and have demonstrated ability to improve clinical outcomes. However, all require invasive arterial or venous catheters, with associated risks of infection, thrombosis and vascular injury. Non-invasive monitoring of cardiac output and fluid responsiveness in infants and children is an active area of interest and several proven techniques are available. Novel non-invasive cardiac output monitors offer a promising alternative to echocardiography and have proven their ability to influence clinical practice. Assessment of perfusion remains a challenge; however, technologies such as near-infrared spectroscopy and photoplethysmography may prove valuable clinical adjuncts in the future.
心输出量监测使对危重症儿童进行生理学导向的管理成为可能，并有助于早期发现临床恶化。已经开发出多种有创技术，并已证明这些技术能够改善临床结果。但是，所有这些技术都需要有创的动脉或静脉导管，并且存在感染、血栓形成和血管损伤的风险。在婴儿和儿童中对心输出量和液体反应性进行非侵入性监测是一个活跃的研究领域，并且有多种经过验证的技术。新型的非侵入性心输出量监测器为超声心动图提供了一种很有前途的替代方法，并且已经证明了它们影响临床实践的能力。对灌注的评估仍然是一个挑战；但是，近红外光谱和光电容积描记术等技术在未来可能会成为有价值的临床辅助手段。
