不同循环障碍的血管活性药物使用

Use of vasoactive agents in different shock

危重儿童循环障碍的识别和治疗始终是儿童重症医学的重要内容。改善循环功能，稳定血流动力学是关键。不同的循环障碍类型，如低血容量性休克、心源性休克、分布性休克和梗阻性休克的血流动力学变化不尽相同。充足液体复苏后的低血压和器官低灌注，启用血管活性药物。选择血管活性药物的关键是明确治疗的目的。尽管休克的病理生理改变很复杂，了解休克的病理改变，血管活性药物的作用机制，目前研究的现状对临床比较正确地选择血管活性药物很有帮助。

Circulatory failure recognition and treatment represents an important issue in critically ill infants and children.Improvement of cardiocirculatory disability and stabilization of hemodynamic is the key step.Hemodynamic variations among different types of shocks,such as hypovolemic,cardiogenic,distributive and obstructive shock,are different.When fluid administration fails to restore adequate arterial pressure and organ perfusion,vasoactive agents should be considered.The key to selecting among vasoactive agents is to consistent with the context of the goals of therapy.Despite the complex pathophysiology of shock,choose of right vasoactive agents for hemodynamic support of patients with shock can be guided by acknowledged pathological changes,mechanisms of vasoactive agents and current studies.