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重症心脏超声在评估机械通气撤机失败中的研究现状 被引量:9
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作者 陈文秀 穆心苇 《中国心血管杂志》 2017年第4期296-299,共4页
机械通气是重症患者重要的呼吸支持手段,机械通气时间延长或缩短均会对患者造成不利影响。因此,准确地评估及判定撤机时间是重症患者治疗过程中的重点及难点。撤机过程可引起心血管及呼吸系统的一系列病理生理变化:如胸内压显著下降、... 机械通气是重症患者重要的呼吸支持手段,机械通气时间延长或缩短均会对患者造成不利影响。因此,准确地评估及判定撤机时间是重症患者治疗过程中的重点及难点。撤机过程可引起心血管及呼吸系统的一系列病理生理变化:如胸内压显著下降、呼吸功增加、肾上腺素能激活、低氧血症、高碳酸血症等,它们被认为是撤机所致心原性肺水肿的主要机制。最新的一系列研究提示,患者的心功能可能是影响撤机成败的关键因素之一。重症心脏超声近年来在许多疾病中均得到了广泛的研究与应用。最新研究提示,重症心脏超声能够帮助预测撤机失败,并且诊断是否为心原性原因引起。因此,重症心脏超声可能能够为指导成功撤机提供新思路。 展开更多
关键词 机械通气 通气机撤除法 重症心脏超声
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发展重症经食管心脏超声 完善重症超声体系 被引量:4
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作者 王小亭 尹万红 +1 位作者 李易 刘大为 《中华内科杂志》 CAS CSCD 北大核心 2019年第12期865-868,共4页
重症医学的飞速发展对监测治疗手段提出了非常高的要求。在此背景下,超声技术因其非常适应当今重症精准诊治的需求而被重症专业医师接纳,整合了重症医学理念,广泛用于重症救治的各个方面以提高诊疗质量。经食管心脏超声作为超声技术的... 重症医学的飞速发展对监测治疗手段提出了非常高的要求。在此背景下,超声技术因其非常适应当今重症精准诊治的需求而被重症专业医师接纳,整合了重症医学理念,广泛用于重症救治的各个方面以提高诊疗质量。经食管心脏超声作为超声技术的重要组成,具有区别于体表超声的独特优势,特别是在进行多维度精细血流动力学监测、作为平台拓展其他高级超声技术的应用等方面,具有不可估量的价值。但是,正如重症超声不同于传统超声一样,应用于重症患者的经食管心脏超声亦需要进行重症化的打造,才能适合重症救治的需求。因此,建立重症经食管心脏超声的概念,阐明其内涵特点及价值尤为重要。 展开更多
关键词 重症经食管心脏超声 重症超声 重症医学
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中国重症经食管超声临床应用专家共识(2019) 被引量:16
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作者 尹万红 王小亭 +9 位作者 刘大为 康焰 晁彦公 张丽娜 张宏民 武钧 刘丽霞 朱然 何伟 《中华内科杂志》 CAS CSCD 北大核心 2019年第12期869-882,共14页
经食管心脏超声(TEE)因其自身的特点和优势,非常适合重症患者诊治的需求而得以在ICU中应用。但由于重症患者诊治的特殊性,目前的应用方式尚未完全适应重症医学的特点,进而限制了其优势的发挥。因此我们结合自己的临床探索实践及国外研究... 经食管心脏超声(TEE)因其自身的特点和优势,非常适合重症患者诊治的需求而得以在ICU中应用。但由于重症患者诊治的特殊性,目前的应用方式尚未完全适应重症医学的特点,进而限制了其优势的发挥。因此我们结合自己的临床探索实践及国外研究,在重症医学理论指引下,将传统TEE拓展和改进并整合重症医学理念,确立了重症经食管心脏超声(TEECC)的概念,梳理了相关理念与应用规范,制定了《中国重症经食管超声临床应用专家共识(2019)》,旨在阐明TEECC的本质与特点准动TEECC合理、规范的临床应用,建立规范的TEECC理论体系,引导TEECC实践和临床科研的规范的健康发展,逐步完善TEECC临床应用的理论与实践,提高临床救治水平。 展开更多
关键词 重症经食管心脏超声 重症医学 共识
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Effect of Focused Cardiac Ultrasound in Combination with Lung Ultrasound on Critically Ill Patients: A Multicenter Observational Study in China 被引量:1
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作者 Hongmin Zhang Lina Zhang +9 位作者 Lixia Liu Ying Zhu Wanhong Yin Wei He Xiuling Shang Yangong Chao Liwen Lv Xiaoting Wang Dawei Liu 《Chinese Medical Sciences Journal》 CAS CSCD 2021年第4期257-264,共8页
Objective Focused cardiac ultrasound(FCU)and lung ultrasound(LU)are increasingly being used in critically ill patients.This study aimed to investigate the effect of FCU in combination with LU on these patients and to ... Objective Focused cardiac ultrasound(FCU)and lung ultrasound(LU)are increasingly being used in critically ill patients.This study aimed to investigate the effect of FCU in combination with LU on these patients and to determine if the timing of ultrasound examination was associated with treatment change.Methods This is a multicenter cross-sectional observational study.Consecutive patients admitted to the intensive care unit(ICU)were screened for enrollment.FCU and LU were performed within the first 24 h,and treatment change was proposed by the performer based on the ultrasound results and other clinical conditions.Results Among the 992 patients included,502 were examined within 6 h of ICU admission(early phase group),and 490 were examined after 6 h of admission(later phase group).The early phase group and the later phase group had similar proportions of treatment change(48.8%vs.49.0%,χ^(2)=0.003,P=0.956).In the multivariable analysis,admission for respiratory failure was an independent variable associated with treatment change,with an odds ratio(OR)of 2.357[95%confidence interval(CI):1.284-4.326,P=0.006];the timing of examination was not associated with treatment change(OR=0.725,95%CI:0.407-1.291,P=0.275).Conclusions FCU in combination with LU,whether performed during the early phase or later phase,had a significant impact on the treatment of critically ill patients.Patients with respiratory failure were more likely to experience treatment change after the ultrasound examination. 展开更多
关键词 cardiac ultrasound lung ultrasound critically ill POINT-OF-CARE
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BILL Strategy:Points to Consider During the Performance and Interpretation of Critical Care Echocardiography
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作者 Hong-Min Zhang Hui Lian Xiao-Ting Wang 《Chinese Medical Sciences Journal》 CAS 2024年第3期234-241,共8页
The growing utilization of critical care echocardiography(CCE)by clinicians necessitates a meticulous review of clinical conditions in critically ill patients,both before and during the examination.The reviewing proce... The growing utilization of critical care echocardiography(CCE)by clinicians necessitates a meticulous review of clinical conditions in critically ill patients,both before and during the examination.The reviewing process of clinical conditions minimizes the risk of overlooking or misinterpreting crucial findings.This article proposes a comprehensive strategy,namely BILL strategy to integrated into the CCE protocol,where“B”represents baseline respiratory and hemodynamic support,“I”signifies information gleaned from invasive monitoring,including central venous pressure and thermodilution-derived cardiac output,the first“L”denotes laboratory results such as central venous oxygen saturation,troponin,and brain natriuretic peptide,and the second“L”refers to lung ultrasound data.xx Combining the BILL strategy with CCE enhances a more comprehensive understanding of critical illness,potentially leading to improved diagnostic accuracy and patient outcomes. 展开更多
关键词 echocardiography critical care clinical condition
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