围绕手术质量倡议就目标定向的血液动力学治疗的共识声明
Mark R Edwards1, Gudrun Kunst2, Lui G Forni3
1Perioperative and Critical Care Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton/University of Southampton, Southampton, UK.
British journal of anaesthesia
|July 10, 2025
概括
更新的共识陈述建议考虑针对特定手术患者的目标定向血动力学治疗 (GDHT),但要谨慎对其他患者的常规使用. 未来的研究应该专注于个性化GDHT和人工智能驱动的预测模型.
科学领域:
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 外科手术的结果
背景情况:
- 外科手术期间的目标导向血动力学疗法 (GDHT) 涉及手术期间管理循环功能的协议.
- 第十一届经营性质量倡议 (POQI) 召开,以更新关于经营性GDHT的共识声明.
研究的目的:
- 提出关于术后GDHT的定义,组成部分和生理学的更新共识陈述.
- 为GDHT在各种手术环境中使用提供基于证据的建议.
主要方法:
- 经营性质量倡议 (POQI) 的共识开发会议.
- 对GDHT的现有证据和专家意见的审查和综合.
主要成果:
- 建议在特定情况下考虑GDHT,如心肺绕道,心脏后手术和关节骨折手术,尽管证据很弱.
- 对于接受重大非心脏手术的中度至高风险患者,可以使用GDHT协议,但不建议使用固定的低剂量异型药物.
- 常规GDHT不推用于选择性腹部手术,而对于紧急腹部手术的证据是不够的.
结论:
- 根据手术背景和患者的风险,GDHT的应用需要仔细考虑.
- 未来的研究应该优先考虑个性化的GDHT,技术辅助协议和AI在血液动力学管理的预测建模中.
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