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关于床旁超声心动图在心力衰竭中应用的立场声明:来自西班牙内科协会(SEMI)心力衰竭与心房颤动以及临床超声工作组的建议

Position statement on the use of point-of-care ultrasound in heart failure: recommendations from the Heart Failure and Atrial Fibrillation, and Clinical Ultrasound Working Groups of the Spanish Society of Internal Medicine (SEMI).

作者信息

Tung-Chen Y, Beltrán Robles M, Rubio Gracia J, García de Casasola Sánchez G, Llàcer Iborra P, García Rubio S, Méndez Bailón M, Montero Hernández E, Sánchez-Marteles M, Torres Arrese M, Torres Macho J, Pérez Silvestre J

机构信息

Grupo de Trabajo de Ecografía Clínica de la SEMI (GTEco-SEMI); Servicio de Medicina Interna, Hospital Universitario la Paz, Madrid, Spain.

Servicio de Medicina Interna, Hospital Virgen del Camino, Sanlúcar de Barrameda, Cádiz; Grupo de trabajo de InsuficienciaCardíaca Y Fibrilación Auricular de la SEMI (ICYFA), Spain.

出版信息

Rev Clin Esp (Barc). 2025 Mar;225(3):148-156. doi: 10.1016/j.rceng.2025.01.003. Epub 2025 Jan 23.

Abstract

This document provides a comprehensive analysis of the use of point-of-care ultrasound in heart failure (HF), offering detailed recommendations on echocardiography, lung ultrasound, and venous ultrasound. These advanced imaging techniques allow for an accurate, detailed, and non-invasive evaluation of heart failure, facilitating rapid and effective clinical decision-making. Echocardiography enables a rapid assessment of cardiac function at the point of care, enhancing traditional physical examination and being essential for the management of heart failure (HF). Lung ultrasound provides a detailed view of the pulmonary status, crucial for diagnosing pulmonary congestion without using ionizing radiation, ideal for continuous monitoring. Venous ultrasound evaluates systemic congestion by measuring the inferior vena cava and other parameters, aiding in the estimation of right atrial pressure and monitoring pressure and volume overload, improving patient understanding and prognosis. Together, the use of these ultrasound modalities not only complements but enriches the traditional physical examination, establishing themselves as indispensable tools in the comprehensive and effective management of patients with heart failure. By incorporating these techniques into clinical practice, healthcare professionals can achieve better evaluation, diagnosis, and treatment, resulting in more personalized management of these patients.

摘要

本文档对床旁超声心动图在心力衰竭(HF)中的应用进行了全面分析,就超声心动图、肺部超声和静脉超声提供了详细建议。这些先进的成像技术能够对心力衰竭进行准确、详细且无创的评估,有助于快速有效地做出临床决策。超声心动图能够在床旁快速评估心脏功能,强化传统体格检查,对心力衰竭(HF)的管理至关重要。肺部超声可提供肺部状况的详细视图,对于在不使用电离辐射的情况下诊断肺淤血至关重要,非常适合持续监测。静脉超声通过测量下腔静脉及其他参数评估全身淤血情况,有助于估计右心房压力以及监测压力和容量超负荷,增进患者的了解并改善预后。总之,这些超声检查方式的应用不仅补充而且丰富了传统体格检查,成为心力衰竭患者全面有效管理中不可或缺的工具。通过将这些技术纳入临床实践,医护人员能够实现更好的评估、诊断和治疗,从而对这些患者进行更个性化的管理。

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