肝移植血流动力学监测“血流动力学系统”。

IF 1.8 4区 医学 Q3 TRANSPLANTATION
Sherif Kandil, Ashraf Sedra
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引用次数: 0

摘要

综述目的:本文旨在对肝移植血流动力学监测进行综述。最近发现:桡动脉血压监测低估了主动脉根动脉血压,导致血管加压过度和更糟糕的结果。肱动脉和股动脉监测耐受性良好,应考虑在危重患者预期高剂量的压力。肺动脉导管是血流动力学监测的金标准,目前仍广泛应用于肝移植;然而,它是一种高侵入性监护仪,有可能出现严重并发症,其大部分数据可以通过其他侵入性较小的监护仪获得。抢救经食管超声心动图依赖于几个简单的视图,应作为处理突发性血流动力学不稳定的备用。肝移植患者经食管超声心动图显示食管出血的风险与其他患者相同。基于动脉脉冲波形分析的心输出量装置具有微创性和实时监测心输出量的优点。没有血流动力学监测可以改善临床结果,除非整合到目标导向的血流动力学治疗。血流动力学监测技术应根据患者的医疗状况、手术技术和麻醉师的专业水平进行调整。摘要:本文综述了当前血流动力学监测系统及其在目标导向血流动力学治疗中的应用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hemodynamic monitoring in liver transplantation 'the hemodynamic system'.

Purpose of review: The purpose of this article is to provide a comprehensive review of hemodynamic monitoring in liver transplantation.

Recent findings: Radial arterial blood pressure monitoring underestimates the aortic root arterial blood pressure and causes excessive vasopressor and worse outcomes. Brachial and femoral artery monitoring is well tolerated and should be considered in critically ill patients expected to be on high dose pressors. The pulmonary artery catheter is the gold standard of hemodynamic monitoring and is still widely used in liver transplantation; however, it is a highly invasive monitor with potential for serious complications and most of its data can be obtained by other less invasive monitors. Rescue transesophageal echocardiography relies on few simple views and should be available as a standby to manage sudden hemodynamic instability. Risk of esophageal bleeding from transesophageal echocardiography in liver transplantation is the same as in other patient populations. The arterial pulse waveform analysis based cardiac output devices are minimally invasive and have the advantage of real-time beat to beat monitoring of cardiac output. No hemodynamic monitor can improve clinical outcomes unless integrated into a goal-directed hemodynamic therapy. The hemodynamic monitoring technique should be tailored to the patient's medical status, surgical technique, and the anesthesiologist's level of expertise.

Summary: The current article provides a review of the current hemodynamic monitoring systems and their integration in goal-directed hemodynamic therapy.

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来源期刊
CiteScore
4.10
自引率
4.50%
发文量
124
审稿时长
6-12 weeks
期刊介绍: ​​​​​​Current Opinion in Organ Transplantation is an indispensable resource featuring key, up-to-date and important advances in the field from around the world. Led by renowned guest editors for each section, every bimonthly issue of Current Opinion in Organ Transplantation delivers a fresh insight into topics such as stem cell transplantation, immunosuppression, tolerance induction and organ preservation and procurement. With 18 sections in total, the journal provides a convenient and thorough review of the field and will be of interest to researchers, surgeons and other healthcare professionals alike.
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