在静脉内体积复苏后的败血性休克中,酸甘
Peter E Spronk1, Can Ince, Martin J Gardien
1Department of Intensive Care Medicine, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands.
Lancet (London, England)
|November 9, 2002
概括
酸甘油改善了性休克患者的微循环血液流动. 这表明,增强微循环可能是败血性休克的新复苏目标.
科学领域:
- 临界护理医学 临界护理医学
- 生理学 生理学 生理学
- 医疗成像医学成像
背景情况:
- 败血性休克涉及氧气消耗增加和由于微循环功能障碍导致的输送/提取受损.
- 微循环关闭和变流有助于在败血症冲击中氧化受损.
- 正角极化光谱 (OPS) 图像提供了微循环的直接可视化.
研究的目的:
- 评估酸甘对败血症休克患者微循环流量的影响.
- 评估微循环征集作为复苏终点的潜力.
主要方法:
- 使用直角偏振光谱 (OPS) 图像来可视化微循环.
- 监测的患者有败血性休克和特定的血液动力学参数 (MAP> 60 mm Hg,CVP> 12 mm Hg).
- 静脉注射尼特洛甘油 (0.5毫克) 并观察到微血管流量的变化.
主要成果:
- 通过OPS成像观察到,酸甘输注导致了微血管流量的显著增加.
- 经过尼甘的使用后,显然改善了微循环 perfusion.
- 观察到微循环的增强招募.
结论:
- 酸甘油有效地改善了在败血症休克时的微循环血流.
- 微循环的招募可以作为一个新的和有价值的复苏终点在败血症冲击管理.
- OPS成像是一种可行的工具,用于评估微循环对危急疾病干预措施的反应.
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