关于2025年循环冲击和血液动力学监测的ESICM指南
Xavier Monnet1, Antonio Messina2,3, Massimiliano Greco2,3
1Université Paris-Saclay, Faculté de Médecine, Service de médecine intensive-réanimation, Hôpital de Bicêtre, AP-HP, DMU 4 CORREVE Maladies du cœur et des vaisseaux, IHU SEPSIS, Groupe de recherche clinique CARMAS, Le Kremlin-Bicêtre, France. xavier.monnet@aphp.fr.
Intensive care medicine
|November 14, 2025
概括
这些指导方针提供了50条建议,用于诊断严重病情的成年人的休克和监测血液动力学. 关键建议包括使用动态变量评估皮肤 perfusion,静脉氧和液体反应.
科学领域:
- 关键护理医学 关键护理医学
- 血液动力学 血液动力学
- 冲击管理的管理.
背景情况:
- 冲击和血液动力学不稳定是成年重症监护的关键问题.
- 准确的诊断和监测对于有效的患者管理至关重要.
- 现有的指南需要根据当前的证据和专家共识进行更新.
研究的目的:
- 为诊断休克提供基于证据的建议.
- 制定关键病情的成年患者血液动力学监测指南.
- 在重症监护机构标准化对冲击管理的方法.
主要方法:
- 一个国际专家小组制定了PICO问题.
- 使用了推评估,开发和评估 (GRADE) 的分级方法.
- 在没有强有力的证据的情况下,发布了未评级的良好实践声明 (UGPS).
主要成果:
- 发表了50份声明,涵盖了冲击诊断和血液动力学监测.
- 建议包括监测皮肤输液 (毛细血管补充,温度,斑点),静脉氧和和二氧化碳差异.
- 建议使用动态变量和心声回声学来确定冲击类型的流体响应性评估.
结论:
- 该小组制定了50条关于冲击诊断和血液动力学监测的综合建议.
- 这些指导方针旨在改善危急病患者的护理.
- 这些建议强调了对血液动力学评估和管理的结构化方法.
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