个性化氧化的生理基础是针对患有循环休克的危急病患者
Anne-Aylin Sigg1, Vanja Zivkovic2, Jan Bartussek2
1Institute of Intensive Care Medicine, University Hospital of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland. anne-aylin.sigg@usz.ch.
在循环休克中优化氧气输送需要平衡风险和收益. 个性化微循环目标,而不仅仅是全球变量,对于改善患者的治疗结果和避免高氧化症至关重要.
科学领域:
- 关键护理医学 关键护理医学
- 身体生理学 身体生理学
- 血液动力学 血液动力学
背景情况:
- 循环休克,其特点是组织 perfusion 不充分,呈现出高发病率和死亡率.
- 目前的治疗重点是全球血液动力学变量,如心脏输出量和氧和度.
- 确定支持微循环功能的最佳目标仍然是一个挑战.
研究的目的:
- 审查向组织输送氧气的生理基础.
- 评估当前关于重症患者补充氧气的文献.
- 强调床边决策的风险-收益考虑.
主要方法:
- 对氧气输送的生理机制的文献综述.
- 对临床试验的分析,重点关注宏循环和氧化目标.
- 对各种氧化目标及其影响的研究的评估.
主要成果:
- 系统循环通过微循环调整来调节氧气供应.
- 过氧会导致氧基的产生和细胞死亡.
- 临床试验显示了有关氧化位的相互矛盾的结果,这表明U形效应.
结论:
- 恢复组织输液和避免高氧是循环休克复苏的关键.
- 个性化微循环目标将变得越来越重要.
- 需要进一步的研究来确定患者护理的最佳目标.
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