Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute.
School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
Curr Opin Crit Care. 2024 Dec 1;30(6):629-636. doi: 10.1097/MCC.0000000000001205. Epub 2024 Sep 7.
This editorial aims to highlight the evolving concept of protective hemodynamics in the management of critically ill patients.
Recent literature underscores the limitations of rigid blood pressure targets, particularly in the context of critical care and perioperative management. High blood pressure targets, especially when coupled with high-dose vasopressors, can lead to poor outcomes. 'Protective hemodynamics' aims to maintain cardiovascular stability while reducing risks associated with interventions.
The implications of adopting protective hemodynamics are profound for both clinical practice and research. Clinically, this approach can reduce iatrogenic harm and improve long-term outcomes for critically ill patients. For research, it opens new avenues for investigating individualized hemodynamic management strategies that prioritize overall patient stability and long-term health over rigid target attainment.
本社论旨在强调在危重病患者管理中不断发展的保护性血流动力学概念。
最近的文献强调了严格血压目标的局限性，特别是在重症监护和围手术期管理的背景下。高血压目标，尤其是与大剂量血管加压素联合使用时，会导致不良结果。“保护性血流动力学”旨在在维持心血管稳定性的同时降低干预相关的风险。
采用保护性血流动力学对临床实践和研究都有深远的影响。从临床角度来看，这种方法可以减少医源性伤害，改善危重病患者的长期预后。对于研究而言，它为研究个性化血流动力学管理策略开辟了新途径，这些策略优先考虑整体患者稳定性和长期健康，而不是严格的目标实现。
