关键病患ARDS的流体管理策略:一个叙事审查
Mairi Ziaka1, Aristomenis Exadaktylos2
1Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, Bern, Switzerland. mairi.ziaka@gmail.com.
在急性呼吸窘迫综合征 (ARDS) 中,管理液体平衡至关重要. 个性化流体策略至关重要,以避免诸如高血症或低血等并发症,改善患者的治疗结果.
科学领域:
- 关键护理医学 关键护理医学
- 肺部病理学 肺部病理学
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 急性呼吸窘迫综合征 (ARDS) 患者的高血压与不良结果相关,包括更长的ICU停留时间,增加机械通风持续时间和更高的死亡率.
- 相反,限制性流体管理可能会导致低 perfusion 和器官功能障碍,例如急性损伤.
研究的目的:
- 探索ARDS重症患者最佳流体管理的挑战和策略.
- 突出基于患者特异性因素和疾病进展的个性化液体管理的需要.
主要方法:
- 关于ARDS流体管理的当前文献的综述.
- 讨论"救援,优化,稳定和降级"战略.
- 重点是个性化的血液动力学和临床参数评估.
主要成果:
- 流体过载与ARDS的预后不佳有关.
- 流体限制可能导致有害的低 perfusion 和器官功能障碍.
- 最佳的流体管理需要一个动态的,个性化的方法.
结论:
- 在ARDS中注射液体是复杂的,需要量身定制的策略,考虑到毒症或急性脑损伤 (ABI) 等并发症.
- "救援,优化,稳定和降级"的方法提供了初步指导.
- 在使用利尿剂或置换疗法 (RRT) 达到负流体平衡目标之前,应该达到血液动力学稳定.
更多相关视频
08:12Invasive Hemodynamic Monitoring of Aortic and Pulmonary Artery Hemodynamics in a Large Animal Model of ARDS
Published on: November 26, 2018
06:22Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome ARDS
Published on: April 7, 2021
相关概念视频
Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Acute Respiratory Failure-IV
Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
Acute Respiratory Failure-III
Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
Endotracheal Tube Extubation
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
