感染性休克血流动力学的监测指标
血流动力学;休克;脓毒症,,血流动力学;休克;脓毒症,关键词:血流动力学;休克;脓毒症,参考文献:
摘要: 血流动力学的监测对感染性休克(septic shock)的早期诊断、预后的判断以及治疗终点的选择、效果的观察、方案的调整均至关重要。septic shock组织灌注的监测是血流动力学监测的核心内容,包括全身以及局部灌注指标的监测。全身灌注指标包括氧输送(DO2)、氧消耗(VO2)、血乳酸水平、混合静脉血氧饱和度(SVO2)或中心静脉血氧饱和度(ScVO2)等。局部灌注指标包括胃黏膜张力测定、舌下二氧化碳测定以及近年来出现的正交极化光谱成像(OPS)等。心功能的监测也是septic shock患者血流动力学监测的重要内容。经典的血流动力学监测通过SwanGanz导管来完成,近年来出现了一些新的无创或微创测定心排量的方法,但还不能够完全替代SwanGanz导管。关键词:血流动力学;休克;脓毒症
Parameters for hemodynamic monitoring in septic shock
GUAN Xiangdong,KOU Qiuye
(SICU,The First Affiliated Hospital of Sun Yatsen University,Guangzhou 510080,China)
Abstract: Hemodynamic monitoring is crucial in every step of the treatment of septic shock such as early diagnosis,prognosis evaluation,endpoint selection,effectiveness judgement and plan regulation.The core of hemodynamic montoring in septic shock is the montoring of tissue perfusion which includes the global perfusion monitoring—its parameters includes oxygen delivery(DO2),oxygen consumption(VO2),plasma lactate level,SVO2,ScVO2 and so on—and the regional perfusion monitoring,the parameters of which contains gastric mucosal PCO2(PiCO2),partial pressure of sublingual carbon dioxide(PslCO2),orthogonal polarization spectral imaging (OPS).Another important target of hemodynamic montoring is heart function.Some new noninvasive or minor invasive techniques for cardial output measuring,developed and reported in the past few years,have not yet replaced the SwanGanz catheter,the classical method for hemodynamic monitoring. ......
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