在神经临界护理中以自我调节为指导的个性化动脉血压管理
Jonathan R Gomez1, Bhagyashri U Bhende1, Rohan Mathur1
1Division of Neurosciences Critical Care, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Neurology, Johns Hopkins University School of Medicine, USA; Department of Anesthesiology & Critical Care Medicine, Johns Hopkins University School of Medicine, USA.
大脑自身调节 (CA) 对于维持大脑血液流动至关重要. 监测CA和个性化关键疾病的动脉血压目标,可以通过预防hyperfusion来改善患者的结果.
科学领域:
- 神经科学是一个神经科学.
- 生理学 生理学 生理学
- 临界护理医学 临界护理医学
背景情况:
- 大脑自调节 (CA) 维持了稳定的脑血流,尽管动脉血压 (ABP) 的波动.
- 使用侵入性或非侵入性方法进行CA监测是可行的.
- 在各种关键条件下观察到改变CA,影响患者的预后.
研究的目的:
- 对健康人群中CA的生理学和监测进行审查.
- 总结CA变化和各种病态状态的结果.
- 检查患者护理中个性化ABP目标的证据.
主要方法:
- 对CA生理学和监测技术的文献综述.
- 对中风,出血,败血症和心脏骤停后的CA研究的分析.
- 对个性化ABP管理策略的研究评估.
主要成果:
- 在诸如中风和败血症等危急疾病中,CA会发生变化,与更糟糕的结果相关联.
- 标准ABP目标可能对CA受损的患者有害.
- 个性化ABP管理显示出改善临床结果的希望.
结论:
- 在管理重症患者时,CA监测和个性化的ABP目标至关重要.
- 个性化的ABP策略可以减轻与固定目标相关的风险.
- 需要进一步的研究来优化CA引导疗法.
更多相关视频
11:26Assessing Cerebral Autoregulation via Oscillatory Lower Body Negative Pressure and Projection Pursuit Regression
Published on: December 10, 2014
05:01A Detailed Protocol for Physiological Parameters Acquisition and Analysis in Neurosurgical Critical Patients
Published on: October 17, 2017
相关概念视频
Autoregulation of Blood Flow
Chemical Signaling in Autoregulation
Chemical signaling operates at the precapillary sphincter level, inciting either contraction or relaxation....
Neural Regulation of Blood Pressure
Baroreceptor Reflex
Baroreceptors, located in the carotid sinuses and aortic arch, detect changes in blood pressure. When blood pressure rises, these stretch-sensitive receptors...
Pre-Procedural Guidelines for Assessing Blood Pressure
Blood Pressure
The average BP in an adult is typically around 120/80 mmHg (millimeters of mercury). In this measurement, the numerator (120) indicates the systolic pressure, which is the pressure in the arteries during the contraction of the heart's ventricles as blood is expelled. The denominator (80) represents the...
Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Errors occurring during blood pressure monitoring
Several factors...
