脓毒性休克容量反应性评估的进展

Advances in Volume Responsiveness Assessment for Septic Shock

脓毒症作为一种高发病率及死亡率的疾病,其并发脓毒性休克已成为危重症患者死亡的主要原因。脓毒性休克治疗的初始环节之一是液体复苏,其目的是通过增加心脏前负荷使心排血量增加,从而增加组织灌注、减轻器官功能障碍。因此,及时选择有效的血流动力学指标评估容量状况及容量反应性非常重要。其中容量反应性是指快速补液后,心排量随之增加的现象,容量反应性是液体复苏的最基本前提,对改善组织灌注,减少补液盲目性,降低脓毒性休克患者死亡率具有非常重要的意义。

Sepsis is a disease with high morbidity and mortality,and its complicated septic shock has become the main cause of death in critically ill patients.One of the initial steps of septic shock treatment is fluid resuscitation,which aims to increase cardiac output by increasing cardiac preload,thereby increasing tissue perfusion and reducing organ dysfunction.Therefore,it is very important to select effective hemodynamic indexes to evaluate the volume status and volume responsiveness in time.Volume responsiveness refers to the phenomenon that the cardiac output increases after rapid fluid infusion.Volume responsiveness is the most basic premise of fluid resuscitation,which is of great significance for improving tissue perfusion,reducing the blindness of fluid infusion and reducing the mortality of patients with septic shock.