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基于急性肾损伤病理生理机制的肾脏血液动力学评估方案：重症超声引导的 ABCDE。

Renal hemodynamic evaluation protocol based on the pathophysiological mechanism of acute kidney injury: Critical Care UltraSound Guided-ABCDE.

机构信息

Department of Critical Care Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China.

Department of Intensive Care Department, Peking Union Medical College Hospital, Beijing, China.

出版信息

Ren Fail. 2023;45(2):2284842. doi: 10.1080/0886022X.2023.2284842. Epub 2023 Nov 23.

DOI:10.1080/0886022X.2023.2284842
PMID:37994455
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11001348/
Abstract

The multiple etiological characteristics of acute kidney injury (AKI) have brought great challenges to its clinical diagnosis and treatment. Renal injury in critically ill patients always indicates hemodynamic injury. The Critical Care UltraSound Guided (CCUSG)-ABCDE protocol developed by the Chinese Critical Ultrasound Study Group (CCUSG), respectively, includes A diagnosis and risk assessment and uses B-mode ultrasound, Color doppler ultrasound, spectral Doppler ultrasound, and contrast Enhanced ultrasound to obtain the hemodynamic characteristics of the kidney so that the pathophysiological mechanism of the occurrence and progression of AKI can be captured and the prognosis of AKI can be predicted combined with other clinical information; therefore, the corresponding intervention and treatment strategies can be formulated to achieve targeted, protocolized, and individualized therapy.

摘要

急性肾损伤（AKI）的多种病因特征给其临床诊断和治疗带来了巨大挑战。危重症患者的肾脏损伤总是提示血流动力学损伤。中国重症超声研究组（CCUSG）制定的Critical Care UltraSound Guided（CCUSG）-ABCDE 方案，分别包括 A 诊断和风险评估，并使用 B 型超声、彩色多普勒超声、频谱多普勒超声和对比增强超声获得肾脏的血流动力学特征，从而捕捉 AKI 发生和进展的病理生理机制，并结合其他临床信息预测 AKI 的预后；因此，可以制定相应的干预和治疗策略，实现有针对性、规范化和个体化的治疗。

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Decreased renal cortical perfusion, independent of changes in renal blood flow and sublingual microcirculatory impairment, is associated with the severity of acute kidney injury in patients with septic shock.肾皮质灌注减少与急性肾损伤的严重程度相关，其与肾血流量变化和舌下微循环障碍无关，发生于感染性休克患者。
Crit Care. 2022 Sep 1;26(1):261. doi: 10.1186/s13054-022-04134-6.
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Shock Resuscitation - the Necessity and Priority of Renal Blood Perfusion Assessment.
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Int Urol Nephrol. 2025 Jun;57(6):1933-1944. doi: 10.1007/s11255-025-04363-y. Epub 2025 Jan 15.
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Healthcare (Basel). 2024 Jul 7;12(13):1356. doi: 10.3390/healthcare12131356.
休克复苏——肾血流灌注评估的必要性与优先性
Aging Dis. 2022 Jul 11;13(4):1056-1062. doi: 10.14336/AD.2022.0105.
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