功能性血流动力学监测的应用及其局限性

The applications and limitations of functional hemodynamic monitoring

背景研究表明常规静态血流动力学监测不能准确反映术中患者的循环容量状态。功能性血流动力学监测是一种崭新的血流动力学监测方式，能动态、准确的预测液体反应性。目的主要介绍功能性血流动力学监测的临床应用及其局限性。内容功能性血流动力学监测是以呼吸运动时心肺相互作用为基本原理，将心室每搏量周期性变化的程度作为衡量指标，以此预测和评估循环系统对液体负荷的反应性，进而对循环容量状态进行判断的血流动力学监测方式。依据不同的监测原理把功能性血流动力学监测指标分成3类，分别介绍3类监测参数的应用和局限肚。趋向功能性血流动力学监测为临床医生进行循环监测提供了更有效、更准确的评估方法，它的应用前景更加光明。

Background It has been shown that static hemodyuamic monitoring may not accurately reflect the volume status of circulation in patients undergoing surgery. Functional hemodynamic monitoring is a new hemodynamic monitoring method and can dynamically and precisely predict fluid responsiveness. Objective This article reviews the applications and limitations of functional hemodynamie monitoring during clinical practice. Content Functional hemodynamic monitoring, based on the principle of heartlung interaction during mechanical ventilation, is served as a prediction of fluid responsiveness and evaluation of circulatory volume state. Functional hemodynamic indices, which reflect cyclical variations in stroke volume, can be divided into three categories according to different monitoring principles. The clinical applications and limitations of these indices are discussed as follows. Trend Functional hemodynamic monitoring can provide a more effective and more accurate assessment method of volume status for clinical doctors with a brighter prospect.