心脏前负荷指标在评估液体反应性中的研究进展

Research progress of cardiac pre-load parameters in evaluating fluid responsiveness

液体复苏是针对重症监护室（ICU）中大部分血流动力学不稳定的危重症患者的首选治疗,但其心功能往往会使液体复苏受到限制,使得液体治疗无反应性,反而可能增加肺水肿的风险.因此,液体反应性好是液体治疗成功的基本前提.对于血流动力学不稳定的患者,为了降低风险,应准确评估液体反应性.目前针对动物和临床患者的静态前负荷指标、动态前负荷指标进行了大量研究,如何避免扩容的盲目性、准确有效地评价和预测液体反应性仍是目前临床的一个巨大挑战.

As the preferred treatment for most patients with hemodynamic instability in the intensive care unit （ICU）,the fluid resuscitation can be limited by the cardiac function,that makes the fluid treatment has no responsiveness and may cause the risk of pulmonary edema increase.So,good fluid responsiveness is the basic condition to make fluid therapy successfully.For those patients,in order to lower the risk and correctly evaluate the fluid responsiveness,there are a large number of studies direct at the static and the dynamic pre-load parameters in animals and clinical patients.Those studies show that how to avoid the blindness of fluid expansion,accurately and effectively evaluate and forecast the fluid responsiveness.