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血容量分析与心肾综合征:从基础到临床。

Blood Volume Analysis and Cardiorenal Syndrome: From Bench to Bedside.

机构信息

School of Public Health, University of Memphis, Memphis, Tennessee, USA.

CC Nurse Consulting, LLC, Saint Paul, Minnesota, USA.

出版信息

Cardiorenal Med. 2024;14(1):483-497. doi: 10.1159/000540497. Epub 2024 Jul 20.

Abstract

BACKGROUND

This review delves into the intricate landscape of cardiorenal syndrome (CRS) and highlights the pivotal role of blood volume analysis (BVA) in improving patient care and outcomes.

SUMMARY

BVA offers a direct and highly accurate quantification of intravascular volume, red blood cell volume, and plasma volume, complete with patient-specific norms. This diagnostic tool enhances the precision of diuretic and red cell therapies, significantly elevating the effectiveness of conventional care.

KEY MESSAGES

Our objectives encompass a comprehensive understanding of how BVA informs the evaluation and treatment of CRS, including its subtypes, pathophysiology, and clinical significance. We delve into BVA principles, techniques, and measurements, elucidating its diagnostic potential and advantages compared to commonly used surrogate measures. We dissect the clinical relevance of BVA in various CRS scenarios, emphasizing its unique contributions to each subtype. By assessing the tangible impact of BVA on patient outcomes through meticulous analysis of relevant clinical studies, we unveil its potential to enhance health outcomes and optimize resource utilization. Acknowledging the challenges and limitations associated with BVA's clinical implementation, we underscore the importance of multidisciplinary collaboration among cardiologists, nephrologists, and other clinicians. Finally, we identify research gaps and propose future directions for BVA and CRS, contributing to ongoing advancements in this field and patients affected by this complicated clinical syndrome.

摘要

背景

本综述深入探讨了心脏肾综合征(CRS)的复杂领域,并强调了血容量分析(BVA)在改善患者护理和结局方面的关键作用。

概要

BVA 提供了对血管内容量、红细胞容量和血浆容量的直接且高度准确的定量,同时具有患者特异性的正常参考值。这种诊断工具提高了利尿剂和红细胞治疗的精确性,极大地增强了常规护理的效果。

关键信息

我们的目标包括全面了解 BVA 如何为 CRS 的评估和治疗提供信息,包括其亚型、病理生理学和临床意义。我们深入探讨了 BVA 的原理、技术和测量方法,阐明了其与常用替代指标相比的诊断潜力和优势。我们剖析了 BVA 在各种 CRS 情况下的临床相关性,强调了其对每个亚型的独特贡献。通过仔细分析相关临床研究,评估 BVA 对患者结局的实际影响,我们揭示了其改善健康结局和优化资源利用的潜力。我们认识到 BVA 在临床实施方面面临的挑战和限制,强调了心脏病专家、肾病专家和其他临床医生之间多学科合作的重要性。最后,我们确定了 BVA 和 CRS 领域的研究空白,并提出了未来的方向,为该领域的持续进展和受这种复杂临床综合征影响的患者做出贡献。

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