危急病患者的血压目标
Karuna Puttur Rajkumar1, Megan Henley Hicks1, Bryan Marchant1
1Wake Forest University School of Medicine, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, US.
Methodist DeBakey cardiovascular journal
|August 7, 2023
概括
在重症监护室 (ICU) 确定最佳血压目标至关重要. 本综述检查了平均压力与输液压力的证据,强调了心脏病患者的个性化目标,以确保末端器官输液并防止失败.
科学领域:
- 关键护理医学 关键护理医学
- 心脏病学 心脏病学
- 血液动力学 血液动力学
背景情况:
- 重症监护室 (ICU) 的血压管理是复杂的,已建立的危害值约为65毫米升的平均压力.
- 干预试验具有挑战性,大多数证据来自回顾性分析.
- perfusion 压力可能是一个比平均压力更关键的目标,特别是在脆弱人群中.
研究的目的:
- 审查目前关于ICU中血压目标的证据.
- 为特殊患者群体确定适当的目标,特别是在心脏病重症监护室.
- 概述与血压管理相关的末端器官衰竭的风险因素和预测因素.
主要方法:
- 现有研究和数据库分析的文献综述.
- 血液动力学原理的分析及其对ICU患者的应用.
- 考虑个性化的患者特征和心脏病理生理学.
主要成果:
- 证据并不强烈支持更高的血压目标,除非在特定的回顾性分析中.
- 建议 perfusion 压力作为一个可能比平均压力更重要的目标.
- 个性化血压目标是必要的,特别是在心脏ICU设置中.
结论:
- 在ICU中的血压目标应根据患者的病情和心脏状况进行个性化.
- 对治疗的监测和定位对于维持足够的末端器官输液至关重要.
- 进一步的研究可能会澄清 perfusion 压力与重症监护机构中平均压力的作用.
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