国际麻醉学与复苏杂志   2020, Issue (3): 4-4
    
基于“心肺交互”的无创循环监测指标评估容量反应性研究进展
彭艺, 高巨1()
1.江苏省苏北人民医院麻醉科
Research advances of fluid responsiveness evaluation by non‑invasive circulatory monitoring indicators based on "heart‑lung interactions"
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摘要:

基于“心肺交互”的动态血流动力学指标是目前指导液体复苏的金标准,但这些指标的监测往往通过有创方法且操作较复杂。近年来,随着每搏连续无创血压监测系统(continuous non‑invasive arterial pressure, CNAP)、血流动力学监测系统和超声测量血流动力学指标等无创手段在临床的出现,这些指标在容量治疗中的应用开辟了新的前景。文章描述了CNAP和超声测量的基于“心肺交互”的动态血流动力学指标及其评估患者容量反应性的临床应用。两种手段在临床上的应用存在一定的争议。CNAP评估患者容量反应性是临床液体治疗的新趋势,但其应用条件有限,故目前不提倡完全采用无创的方法来指导液体治疗。但是,其可以作为有创监测的补充,帮助临床医师进行正确的液体管理,减少不良事件的发生。

关键词: 心肺交互; 超声; 每搏连续无创血压监测系统; 容量反应性
Abstract:

Hitherto, dynamic hemodynamic indicators based on "heart‑lung interactions" are the gold standard for guiding fluid resuscitation, but such indicators often were obtained by invasive monitoring and complexity process. In recent years, with the emergence of non‑invasive methods such as continuous non‑invasive arterial pressure (CNAP), hemodynamic monitoring system and ultrasound monitoring system were used in clinic, new prospects for the application of heart‑lung interactions indicators for volume therapy were opened up. This review describes the dynamic hemodynamics indicators based on "heart‑lung interactions" measured by CNAP system and ultrasound monitoring for estimating the volume responsiveness. Application of both methods has certain debate. Non‑invasive monitoring for assessing volume responsiveness is the trend of clinical fluid therapy. However, it is not currently recommended to use a non‑invasive method to guide fluid therapy because its application conditions are limited. But it can be used as a supplement of invasive monitoring to help doctors perform proper fluid management and reduce adverse events.

Key words: Heart‑lung interactions; Ultrasound; Continuous non‑invasive arterial pressure; Fluid responsiveness