在败血症中以微循环引导的复苏:下一个前沿?
Elisa Damiani1,2, Andrea Carsetti1,2, Erika Casarotta2
1Anesthesia and Intensive Care Unit, Azienda Ospedaliero Universitaria delle Marche, Ancona, Italy.
Frontiers in medicine
|July 21, 2023
概括
语言下视频显微镜检查显示了血症中微循环功能障碍,通常无法通过标准治疗来纠正. 这种技术可以通过评估微血管血流来指导治疗,以获得更好的患者结果.
科学领域:
- 关键护理医学 关键护理医学
- 血液动力学 血液动力学
- 败血症病理生理学病理生理学
背景情况:
- 败血症引起的微循环功能障碍有助于组织脱氧和器官衰竭.
- 标准的血液动力学监测可能不反映微血管 perfusion 状态.
- 在性休克中观察到血液动力学连贯性的损失.
研究的目的:
- 审查语言下视频显微镜在评估与败血症相关的微循环改变中的作用.
- 评估复苏治疗对微血管功能的影响.
- 讨论床边微循环评估的局限性和未来方向.
主要方法:
- 使用舌下视频显微镜实时,非侵入性评估舌下微血管血流.
- 分析了败血症患者的微血管输液及其与结果的相关性.
- 探索了液体复苏,血管压缩剂和内的对微循环的影响.
主要成果:
- 在败血症期间检测到舌下微血管输液的显著变化,与糟糕的结果相关.
- 证明优化的宏-血液动力学并不总是改善微血管输液.
- 突出了宏观和微循环反应 ("血液动力学连贯性") 之间的差异.
结论:
- 语言下视频显微镜是监测败血症中微血管功能障碍的一个有价值的工具.
- 建议微血管监测用于指导和定位在败血性休克时的复苏疗法.
- 克服当前的局限性对于在临床上广泛采用床边微循环评估至关重要.
关键词:
葡萄糖糖的性糖质 (glycocalyx) 是一种微循环是一种微循环.这是一种血症.败血症的冲击是一个令人震惊的现象.语言下视频显微镜.组织 perfusion perfusion 组织 perfusion 组织 perfusion 组织 perfusion 组织 perfusion 组织 perfusion 组织 perfusion 组织 perfusion 组织 perfusion更多相关视频
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