Dynamic monitoring tools for patients admitted to the emergency department with circulatory failure: narrative review with panel-based recommendations.

IF 3.1 4区 医学 Q1 EMERGENCY MEDICINE
European Journal of Emergency Medicine Pub Date : 2024-04-01 Epub Date: 2024-02-16 DOI:10.1097/MEJ.0000000000001103
Ivor S Douglas, Mohammed H Elwan, Marta Najarro, Stefano Romagnoli
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引用次数: 0

Abstract

Intravenous fluid therapy is commonly administered in the emergency department (ED). Despite the deleterious potential of over- and under-resuscitation, professional society guidelines continue to recommend administering a fixed volume of fluid in initial resuscitation. Predicting whether a specific patient will respond to fluid therapy remains one of the most important, but challenging questions that ED clinicians face in clinical practice. Surrogate parameters (i.e. blood pressure and heart rate), are widely used in usual care to estimate changes in stroke volume (SV). Due to their inadequacy in estimating SV, noninvasive techniques (e.g. bioreactance, echocardiography, noninvasive finger cuff technology), have been proposed as a more accurate and readily deployable method for assessing flow and preload responsiveness. Dynamic monitoring systems based on cardiac preload challenge and assessment of SV, by using noninvasive and continuous methods, provide more accurate, feasible, efficient, and reasonably accurate strategy for prediction of fluid responsiveness than static measurements. In this article, we aimed to analyze the different methods currently available for dynamic monitoring of preload responsiveness.

针对急诊科收治的循环衰竭患者的动态监测工具:基于小组建议的叙述性综述。
静脉输液疗法是急诊科(ED)的常用疗法。尽管过度复苏和复苏不足都有可能造成危害,但专业协会的指南仍然建议在初始复苏时使用固定量的液体。预测特定患者是否会对液体疗法产生反应仍然是急诊科临床医生在临床实践中面临的最重要但最具挑战性的问题之一。代用参数(即血压和心率)被广泛应用于常规护理中,以估计每搏量(SV)的变化。由于其在估算 SV 方面的不足,无创技术(如生物反应、超声心动图、无创手指袖带技术)已被提出作为评估血流和前负荷反应性的更准确、更易于部署的方法。与静态测量相比,基于心脏前负荷挑战和 SV 评估的动态监测系统通过使用无创和连续的方法,为预测输液反应性提供了更准确、可行、高效和合理的策略。本文旨在分析目前可用于动态监测前负荷反应性的不同方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.60
自引率
27.30%
发文量
180
审稿时长
6-12 weeks
期刊介绍: The European Journal of Emergency Medicine is the official journal of the European Society for Emergency Medicine. It is devoted to serving the European emergency medicine community and to promoting European standards of training, diagnosis and care in this rapidly growing field. Published bimonthly, the Journal offers original papers on all aspects of acute injury and sudden illness, including: emergency medicine, anaesthesiology, cardiology, disaster medicine, intensive care, internal medicine, orthopaedics, paediatrics, toxicology and trauma care. It addresses issues on the organization of emergency services in hospitals and in the community and examines postgraduate training from European and global perspectives. The Journal also publishes papers focusing on the different models of emergency healthcare delivery in Europe and beyond. With a multidisciplinary approach, the European Journal of Emergency Medicine publishes scientific research, topical reviews, news of meetings and events of interest to the emergency medicine community. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool. ​
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