脓毒性休克血流动力学监测及容量、心功能状态评估

Hemodynamic monitoring, fluid volume and cardiovascular function assessment in septic shock

血流动力学监测是对循环系统血液流动，心脏各腔室压力，体循环、肺循环的压力及阻力等一系列生理病理变化的指标进行监测。脓毒性休克传统血流动力学监测以中心静脉压、心脏指数、血乳酸和pH为重要参考依据。近年来发展的无创或有创监测技术包括中心静脉或混合静脉血氧饱和度、连续无创超声心输出量监测、脉搏指数连续心排血量监测等。宏观血流动力学、代谢指标和微循环参数构成新的血流动力学监测数据网络。临床需要通过对各个参数进行分析与整合，克服单一参数的局限性，才能正确评估患儿容量及循环功能状态。

Hemodynamics is monitoring a series of physiological and pathological parameter changes such as blood flow, the chamber pressure of the heart, pressure or resistance of cardiovascular and cardiopulmonary system. Traditional hemodynamic monitoring in septic shock manily includes central venous pressure, cardiac index ,blood lactate and pH. In recent years, expanded non-invasive or invasive monitoring technolo- gies include central venous or mixed venous oxygen saturation, continuous ultrasound associated with underlying cardiac output monitoring and pulse indicator continuous cardiac output. Macro-hemodynamic, metabolic and microcirculatory parameters constitute a new hemodynamics network. In order to properly assess the patient＇s blood volume and circulation function and to overcome the limitations of a single parameter,it is need to emphasize analysis and integration of the various parameters.