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非心脏手术期间的血流动力学监测:过去、现在和未来。

Haemodynamic monitoring during noncardiac surgery: past, present, and future.

机构信息

Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, 20246, Germany.

Outcomes Research Consortium, Cleveland, OH, USA.

出版信息

J Clin Monit Comput. 2024 Jun;38(3):565-580. doi: 10.1007/s10877-024-01161-2. Epub 2024 Apr 30.

Abstract

During surgery, various haemodynamic variables are monitored and optimised to maintain organ perfusion pressure and oxygen delivery - and to eventually improve outcomes. Important haemodynamic variables that provide an understanding of most pathophysiologic haemodynamic conditions during surgery include heart rate, arterial pressure, central venous pressure, pulse pressure variation/stroke volume variation, stroke volume, and cardiac output. A basic physiologic and pathophysiologic understanding of these haemodynamic variables and the corresponding monitoring methods is essential. We therefore revisit the pathophysiologic rationale for intraoperative monitoring of haemodynamic variables, describe the history, current use, and future technological developments of monitoring methods, and finally briefly summarise the evidence that haemodynamic management can improve patient-centred outcomes.

摘要

在手术过程中,监测和优化各种血流动力学变量以维持器官灌注压和氧输送-并最终改善结果。了解手术期间大多数病理生理血流动力学状况的重要血流动力学变量包括心率、动脉压、中心静脉压、脉压变化/每搏量变化、每搏量和心输出量。对这些血流动力学变量及其相应监测方法的基本生理和病理生理理解是必不可少的。因此,我们重新审视术中血流动力学变量监测的病理生理原理,描述监测方法的历史、当前用途和未来技术发展,并最后简要总结血流动力学管理可以改善以患者为中心的结果的证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/455c/11164815/375c0970cabe/10877_2024_1161_Fig1_HTML.jpg

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