长时间的毛细血管补充时间和血症儿童的微循环变化之间的联系
Jaime Fernández-Sarmiento1, Shirley Lamprea2, Sofia Barrera2
1Department of Critical Care Medicine and Pediatrics, Universidad de La Sabana, Fundación Cardioinfantil-Institute of Cardiology, Bogotà, Colombia. jaimefe@unisabana.edu.co.
BMC pediatrics
|January 20, 2024
概括
败血症儿童的长时间毛细血管补充时间 (PCRT) 与微循环损伤和不良结果有关. 解决PCRT可能会改善小儿败血症的组织输液和患者康复.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 血液动力学 血液动力学
- 微循环研究 微循环研究
背景情况:
- 儿童的败血症可能导致冲击和器官衰竭,长时间的毛细血管补充时间 (PCRT) 表明严重程度.
- 使用视频显微镜进行微循环评估,为血液动力学管理提供了洞察力,特别是在宏观和微循环不一致的情况下.
研究的目的:
- 为了研究延长毛细血管补充时间 (PCRT) 和小儿血症中微循环改变之间的关联.
- 确定PCRT是否可以预测血动力学不一致性和败血症儿童的临床结果.
主要方法:
- 一项前性队列研究,涉及132名住院患有败血症的儿童.
- 微循环通过语言下视频显微镜评估,测量毛细血管密度,流量,透边界区域 (PBR) 和组织透.
- 分析了内皮激活和葡萄糖损伤的生物标志物.
主要成果:
- PCRT与增加的葡萄糖分解 (PBR) 和减少小毛细血管的招募相关.
- 血液动力学不一致与异常PBR相关,其持续性预测了更高的死亡率.
- 升高的二氧化碳差异 (DCO2) 和在入院后延长的CRT预测了异常的PBR和毛细血管血液体积.
结论:
- 在儿科败血症中,长时间的毛细血管补充时间与微循环功能障碍有关,包括招募毛细血管的减少和葡萄糖的降解.
- 这些微循环变化导致氧气输送受损和血液动力学不一致.
- 在24小时内持续异常的CRT显示出更糟糕的结果,并预测更长的住院时间.
相关概念视频
01:29Cardiovascular System Abnormal Findings I: Inspection and Palpation
399
In a cardiovascular examination, inspection and palpation are crucial for identifying abnormalities.
Abnormal findings observed during an inspection
Abnormal findings observed during an inspection
399
01:27Assessment of the Cardiovascular System III: Palpation
342
Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
342