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危重症转运中急性上消化道出血的管理。

Management of Acute Upper Gastrointestinal Bleeding in Critical Care Transport.

机构信息

Lifeguard Air Emergency Services, University of New Mexico Hospital, Albuquerque, NM.

Department of Emergency Medicine, University of New Mexico School of Medicine, Albuquerque, NM.

出版信息

Air Med J. 2023 Mar-Apr;42(2):110-118. doi: 10.1016/j.amj.2022.12.006. Epub 2023 Jan 30.

Abstract

Upper gastrointestinal bleeding is a relatively common and life-threatening condition encountered by critical care transport crews. It is of paramount importance that transport crews understand the underlying pathophysiology of variceal and nonvariceal gastrointestinal bleeding as well as the nuanced management of this patient population. This article reviews the current clinical evidence on initial resuscitation, medical management, and advanced invasive therapies (such as balloon tamponade devices) that transport crews should be familiar with to manage these patients. In addition, we present a novel method of continuous balloon pressure monitoring of balloon tamponade devices that is applicable to the transport environment.

摘要

上消化道出血是重症监护转运人员经常遇到的一种相对常见且危及生命的情况。了解门脉高压性和非门脉高压性胃肠道出血的基本病理生理学以及该患者人群的微妙管理至关重要。本文回顾了关于初始复苏、药物治疗以及转运人员应熟悉的先进侵入性治疗(如气囊填塞装置)的最新临床证据,以治疗这些患者。此外,我们提出了一种适用于转运环境的气囊填塞装置的连续气囊压力监测新方法。

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