目前对肺部外科医生的定量性肺超声波的意见
Nathaniel Reisinger1, Abhilash Koratala2
1Renal Electrolyte and Hypertension Division, University of Pennsylvania, Philadelphia, Pennsylvania.
Current opinion in nephrology and hypertension
|September 27, 2023
概括
肺部超声波有助于管理末期脏病 (ESKD) 患者的液体过载,这些患者正在接受血液透析 (HD). 虽然它没有改善主要的心血管事件,但它有望减少急性护理的使用,并且可以简化临床实践.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 医疗成像医学成像
背景情况:
- 体积过载是末期脏病 (ESKD) 血液透析 (HD) 患者的主要问题,恶化心血管结果和增加急性护理需求.
- 肺堵塞是体积过载的关键指标,在ESKD患者中通常在临床上未被检测出来.
- 肺部超声波 (LUS) 为识别和管理肺堵塞提供了一个潜在的解决方案.
研究的目的:
- 审查目前关于肺超声波在ESKD患者的应用的文献.
- 评估LUS在预测心血管结果和指导HD患者流体管理中的作用.
- 探索简化LUS协议的潜力.
主要方法:
- 对ESKD患者肺部超声波现有文献的综述.
- 对一项大型随机对照试验的分析,该试验调查了LUS引导的超.
- 审查后期分析和最近关于缩写LUS协议的研究.
主要成果:
- 定量性肺超声波有效预测HD的ESKD患者的不良心血管结果.
- 一个以LUS为指导的超过策略可以控制肺堵塞,而不会增加低血压或心律失常等不良事件.
- 虽然初级复合终点没有达到,但特此后分析表明急性护理利用率和心血管事件减少.
- 简化,缩写的LUS协议保留了预后价值.
结论:
- 肺部超声波在科实践中是肺部拥堵的宝贵诊断和管理工具.
- 为了有效的管理策略,要将LUS与血液动力学参数进行最佳整合,需要进一步研究.
- 解决临床医生进行超声波的培训需求对于更广泛的采用至关重要.
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