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即时超声:急诊科脓毒症管理的多模态工具。

Point-of-Care Ultrasound: A Multimodal Tool for the Management of Sepsis in the Emergency Department.

机构信息

Emergency Medicine Department, Attikon University Hospital, 12462 Athens, Greece.

National Centre of Emergency Care (EKAB), 11527 Athens, Greece.

出版信息

Medicina (Kaunas). 2023 Jun 20;59(6):1180. doi: 10.3390/medicina59061180.

Abstract

Sepsis and septic shock are life-threatening emergencies associated with increased morbidity and mortality. Hence, early diagnosis and management of both conditions is of paramount importance. Point-of-care ultrasound (POCUS) is a cost-effective and safe imaging modality performed at the bedside, which has rapidly emerged as an excellent multimodal tool and has been gradually incorporated as an adjunct to physical examination in order to facilitate evaluation, diagnosis and management. In sepsis, POCUS can assist in the evaluation of undifferentiated sepsis, while, in cases of shock, it can contribute to the differential diagnosis of other types of shock, thus facilitating the decision-making process. Other potential benefits of POCUS include prompt identification and control of the source of infection, as well as close haemodynamic and treatment monitoring. The aim of this review is to determine and highlight the role of POCUS in the evaluation, diagnosis, treatment and monitoring of the septic patient. Future research should focus on developing and implementing a well-defined algorithmic approach for the POCUS-guided management of sepsis in the emergency department setting given its unequivocal utility as a multimodal tool for the overall evaluation and management of the septic patient.

摘要

脓毒症和脓毒性休克是危及生命的紧急情况,与发病率和死亡率增加有关。因此,早期诊断和治疗这两种情况至关重要。床边即时超声检查(POCUS)是一种经济有效的安全成像方式,它已迅速成为一种出色的多模态工具,并逐渐被纳入体格检查的辅助手段,以促进评估、诊断和管理。在脓毒症中,POCUS 可辅助评估未分化性脓毒症,而在休克病例中,它有助于鉴别其他类型休克,从而促进决策过程。POCUS 的其他潜在益处包括快速识别和控制感染源,以及密切的血流动力学和治疗监测。本综述旨在确定并强调 POCUS 在评估、诊断、治疗和监测脓毒症患者中的作用。未来的研究应侧重于开发和实施一种明确的算法方法,用于在急诊科中进行 POCUS 引导的脓毒症管理,因为它作为一种多模态工具,对于脓毒症患者的整体评估和管理具有明确的效用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80c4/10303071/d26e31b33abe/medicina-59-01180-g001.jpg

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