自动瞳孔测量技术在急危重症应用的研究进展

Research Progress in Application of Automated Pupillometry in Emergency and Critical Care

瞳孔检查在临床实践中具有重要的诊断和预后价值,目前仍主要依赖传统的手动检查。而应用自动瞳孔测量技术进行定量瞳孔检查,可客观提供数个瞳孔参数,提高测量的准确性和可靠性,优于传统的主观评估。自动瞳孔测量技术在心脏停搏后的早期预后预测,颅脑损伤后的颅内压升高及预后预测,危重症患者镇痛深度的监测,以及危重症患者谵妄的早期预测等方面具有潜在应用价值。然而,目前尚未有指南支持自动瞳孔测量技术在危重症临床环境中常规使用,未来仍需更多大规模、前瞻性研究验证其临床价值。

Pupillary examination,which is mainly relied on traditional manual examination,has fundamental diagnostic and prognostic values in clinical practice.However,quantitative examination with the use of automated pupillometry provides an objective assessment of several pupillary parameters and is superior to the traditional subjective examination.The potential for automated pupillometry is multiple in the setting of critical care,for early outcome prognostication after cardiac arrest,and the early detection of the elevation of intracerebral pressure and outcome prognostication after brain injury,and monitoring of the level of analgesia and early prediction of delirium in critically ill patients.However,no guidelines exist endorsing routine use of automated pupillometry in the setting of critical care,and further large-scale prospective studies are needed to verify its clinical values.