成年人中中央至外围动脉血压梯度的危险因素:系统性审查
Hakim Chala1, Nicolas Daccache2, Louis Morisson2
1Maisonneuve-Rosemont Hospital Research Center, Université de Montréal, Montreal, QC, Canada. hakim.chala@umontreal.ca.
Canadian journal of anaesthesia = Journal canadien d'anesthesie
|January 13, 2026
概括
中心至外围动脉血压梯度 (CPAPGs) 影响高达77%的患者. 复杂的手术和较小的辐射动脉直径是关键的风险因素,需要在重症监护中仔细监测策略.
科学领域:
- 关键护理医学 关键护理医学
- 心血管生理学心血管生理学
- 医疗监控技术 医疗监控技术
背景情况:
- 精确的血液动力学监测在手术和重症监护室 (ICU) 环境中至关重要.
- 辐射动脉导管是标准的,但中心至外围动脉血压梯度 (CPAPGs) 在高达77%的患者中发生.
- CPAPGs可能导致错误的临床决策,强调需要识别有风险的患者.
研究的目的:
- 系统地审查和识别导致CPAPGs的风险因素.
- 评估CPAPGs识别的风险因素的共识程度.
- 为高风险患者的适应性监测策略提供信息.
主要方法:
- 在MEDLINE/PubMed®,Embase和Cochrane数据库中的系统文献搜索.
- 包括在成年患者中同时进行辐射和中心动脉压监测的研究.
- 提取和分析风险因素,评估文献一致性.
主要成果:
- 55项研究 (N=5,598) 评估了CPAPGs在各种环境 (例如心肺绕道,ICU) 中.
- 在90个独特的潜在风险因素中,有36个与CPAPG具有统计学意义的关联.
- 复杂的手术和较小的辐射动脉直径是最一致的预测因素;在一些研究中,血管压缩剂的使用和人口因素 (年龄,身材,性别) 也很重要.
结论:
- 已经确定了CPAPGs的许多危险因素.
- 临床医生应考虑在患有多种已确定的风险因素的患者中进行中央动脉通道.
- 尽量减少不准确的压力测量对于患者护理至关重要.
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