毛细血管补充用于评估败血症中的循环功能障碍:一个范围审查
Robert L Cloutier1, Jessica Bailey1, Matthew Hansen1
1Department of Emergency Medicine Oregon Health and Science University, Portland, OR, United States of America.
The American journal of emergency medicine
|May 9, 2025
概括
毛细血管补充时间 (CRT) 在评估与败血症相关的循环功能障碍方面表现有前途. 然而,需要进一步的研究来提高测量可重现性,并验证其在试验中的临床实用性.
科学领域:
- 关键护理医学 关键护理医学
- 紧急医疗 紧急医疗
- 临床生理学 临床生理学
背景情况:
- 败血症诊断在美国急诊室 (ED) 和重症监护室 (ICU) 中具有挑战性.
- 循环功能障碍是败血症严重程度的关键指标.
研究的目的:
- 对有关毛细血管补充时间 (CRT) 的文献进行范围审查,以评估败血症中的循环功能障碍.
- 了解当前的证据基础,并识别研究缺口.
主要方法:
- 遵守PRISMA指导方针进行范围审查.
- 在OVID Medline (1946-2022) 中进行系统的文献搜索,确定了800篇文章,其中13篇被列入最终分析.
- 包括在ED和ICU设置中测量CRT的研究,评估指甲床颜色回归时间;使用纽卡斯尔-太华评分评估的研究.
主要成果:
- 在包括的13项研究中,证据的强度中等.
- 在CRT测量技术中发现了方法上的缺陷和变化.
- 在不同研究中测量了毛细血管补充的不一致的可重现性.
结论:
- 毛细血管补充时间有可能作为败血症评估中的辅助.
- 需要新兴技术来提高床边测量的可复制性和可靠性.
- 需要前性随机对照试验来验证CRT对患者结果的预测价值.
相关概念视频
01:27Assessment of the Cardiovascular System III: Palpation
157
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...
157
01:29Cardiovascular System Abnormal Findings I: Inspection and Palpation
216
In a cardiovascular examination, inspection and palpation are crucial for identifying abnormalities.
Abnormal findings observed during an inspection
Abnormal findings observed during an inspection
216
01:11Assessment of radial pulse
743
Assessment of Radial Pulse
The radial pulse, located at the wrist, is often the preferred site for assessing peripheral pulse because of its accessibility and dependability. The process of determining the radial pulse involves several steps:
The radial pulse, located at the wrist, is often the preferred site for assessing peripheral pulse because of its accessibility and dependability. The process of determining the radial pulse involves several steps:
743
01:11Pulse Assessment Sites
826
Pulse assessment sites are crucial in evaluating a patient's cardiovascular health. By assessing the pulsations of arteries at specific anatomical locations, healthcare professionals can gather valuable information about blood flow, heart rate, and peripheral circulation. Understanding these pulse assessment sites is essential for conducting comprehensive cardiovascular evaluations and monitoring patients' overall health. These sites are strategically chosen due to the accessibility and...
826
01:29Assessment of the Cardiovascular System II: Inspection
133
Inspection is the initial step in assessing the cardiovascular system. It involves a detailed visual examination that provides crucial information about a patient's circulatory and cardiac health. This systematic process, conducted from head to toe, helps identify signs of cardiovascular conditions by observing physical appearance, skin and mucous membranes, jugular and carotid pulsations, chest symmetry, and the condition of the extremities.
Head and Neck
Head and Neck
133
01:25Assessment of apical radial pulse
685
Apical-Radial (A-R) Pulse Assessment
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation
685