观点:个性化休克复苏的整体四界面概念模型。

IF 3 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Philippe Rola, Eduardo Kattan, Matthew T Siuba, Korbin Haycock, Sara Crager, Rory Spiegel, Max Hockstein, Vimal Bhardwaj, Ashley Miller, Jon-Emile Kenny, Gustavo A Ospina-Tascón, Glenn Hernandez
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引用次数: 0

摘要

休克患者的复苏是一项高度复杂的努力,应该超越正常的平均动脉压和规定的液体负荷。我们提出了一个整体的、四界面的休克概念模型,我们相信这可以使临床医生和研究人员都受益。导致休克的四个循环界面分别是左心室到动脉,动脉到毛细血管,毛细血管到静脉,最后是右心室到肺动脉。我们回顾了这些界面解耦背后的病理生理学和临床后果,以及如何评估它们,并提出了一种接近休克患者的策略。休克床边评估可能包括这些关键界面,以避免血流动力学不一致,并关注微循环恢复,而不是简单地平均动脉压。这个模型的目的是为学习者提供一个心理模型,并为进一步的复苏研究提供一个框架,将这些概念结合起来。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Point of View: A Holistic Four-Interface Conceptual Model for Personalizing Shock Resuscitation.

The resuscitation of a patient in shock is a highly complex endeavor that should go beyond normalizing mean arterial pressure and protocolized fluid loading. We propose a holistic, four-interface conceptual model of shock that we believe can benefit both clinicians at the bedside and researchers. The four circulatory interfaces whose uncoupling results in shock are as follows: the left ventricle to arterial, the arterial to capillary, the capillary to venular, and finally the right ventricle to pulmonary artery. We review the pathophysiology and clinical consequences behind the uncoupling of these interfaces, as well as how to assess them, and propose a strategy for approaching a patient in shock. Bedside assessment of shock may include these critical interfaces in order to avoid hemodynamic incoherence and to focus on microcirculatory restoration rather than simply mean arterial pressure. The purpose of this model is to serve as a mental model for learners as well as a framework for further resuscitation research that incorporates these concepts.

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来源期刊
Journal of Personalized Medicine
Journal of Personalized Medicine Medicine-Medicine (miscellaneous)
CiteScore
4.10
自引率
0.00%
发文量
1878
审稿时长
11 weeks
期刊介绍: Journal of Personalized Medicine (JPM; ISSN 2075-4426) is an international, open access journal aimed at bringing all aspects of personalized medicine to one platform. JPM publishes cutting edge, innovative preclinical and translational scientific research and technologies related to personalized medicine (e.g., pharmacogenomics/proteomics, systems biology). JPM recognizes that personalized medicine—the assessment of genetic, environmental and host factors that cause variability of individuals—is a challenging, transdisciplinary topic that requires discussions from a range of experts. For a comprehensive perspective of personalized medicine, JPM aims to integrate expertise from the molecular and translational sciences, therapeutics and diagnostics, as well as discussions of regulatory, social, ethical and policy aspects. We provide a forum to bring together academic and clinical researchers, biotechnology, diagnostic and pharmaceutical companies, health professionals, regulatory and ethical experts, and government and regulatory authorities.
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