动态监测工具,以循环衰竭进入急诊室的患者:叙述性审查与基于小组的建议
Ivor S Douglas1, Mohammed H Elwan2,3,4, Marta Najarro5
1Denver Health Medical Center, University of Colorado School of Medicine, Denver Colorado, USA.
概括
在急诊室预测患者对静脉注射液体的反应至关重要. 动态监测中风体积为指导流体治疗提供了一种比传统静态参数更准确的方法.
科学领域:
- 关键护理医学 关键护理医学
- 紧急医疗 紧急医疗
- 生理学 生理学 生理学
背景情况:
- 静脉输液治疗是急诊室 (ED) 护理的基石,但精确的流体管理仍然具有挑战性.
- 过度和不足的复苏带有重大风险,突出了需要准确的方法来预测流体反应.
- 当前的指导方针经常建议固定液体体积,这可能不适合所有患者.
研究的目的:
- 分析各种用于动态监控预加载响应性的方法.
- 评估非侵入性技术在评估流体响应性的有效性.
主要方法:
- 对监测中风体积 (SV) 和预装载的非侵入性技术的审查.
- 动态监测系统与静态参数 (如血压,心率) 的比较.
- 对生物反应,心声回声和手指袖技术等技术的评估.
主要成果:
- 静态参数不充分估计冲击体积和流体响应.
- 动态监测系统提供更准确,可行和高效的评估.
- 非侵入性的连续方法为预测流体响应提供了优越的策略.
结论:
- 使用非侵入性方法对预加载响应的动态监测代表了流体管理的重大进步.
- 这些技术使得在紧急情况下可以制定更个性化,更有效的液体复苏策略.
- 进一步采用动态监测可以通过优化流体治疗来改善患者的治疗结果.
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