目标导向液体治疗监测参数和技术研究进展

Research Progress on Monitoring Parameters and Techniques for Goal-Directed Fluid Therapy

目标导向液体治疗(goal-directed fluid therapy, GDFT)通常推荐用于接受大型手术的患者,并且是术后加速康复(enhanced recovery after surgery, ERAS)方案中必不可少的。这种液体治疗方案通常由动态血流动力学参数指导,旨在优化患者的心输出量,以最大限度地向其重要器官输送氧气。虽然许多研究表明GDFT对围手术期患者有益并可减少术后并发症,但对于使用哪些动态血流动力学参数来指导GDFT尚无共识。此外,有许多血流动力学监测技术来测量这些动态血流动力学参数,每种技术都有其优缺点。本文将讨论和回顾常用的GDFT动态血流动力学参数和血流动力学监测技术。Goal-directed fluid therapy (GDFT) is generally recommended for patients undergoing major surgery and is essential in enhanced recovery after surgery ERAS regimens. This fluid regimen is often guided by dynamic hemodynamic parameters and is designed to optimize the patient’s cardiac output to maximize oxygen delivery to their vital organs. Although many studies have shown that GDFT is beneficial in perioperative patients and reduces postoperative complications, there is no consensus on which dynamic hemodynamic parameters should be used to guide GDFT. In addition, there are a number of hemodynamic monitoring techniques to measure these dynamic hemodynamic parameters, each with its advantages and disadvantages. This article will discuss and review commonly used dynamic hemodynamic parameters and hemodynamic monitoring techniques for GDFT.