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 pr...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 integrate 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. Combining the BILL strategy with CCE can enhance comprehensive understanding of critical conditions, potentially leading to improved diagnostic accuracy and patient outcomes.展开更多
目的:探讨6min步行距离试验(6-minute walk test,6MWT)评估合并肺动脉高压的先天性心脏病(先心病)患者手术效果的临床价值。方法:选取2007年3月至2010年2月在我科住院的58例先心病合并肺动脉高压患者。其中男性30例,女性28例;平均年龄(3...目的:探讨6min步行距离试验(6-minute walk test,6MWT)评估合并肺动脉高压的先天性心脏病(先心病)患者手术效果的临床价值。方法:选取2007年3月至2010年2月在我科住院的58例先心病合并肺动脉高压患者。其中男性30例,女性28例;平均年龄(34.5±10.2)岁。心脏超声测量肺动脉收缩压(systolic pulmonary artery pressure,sPAP)。将58例患者按sPAP分为3组,A组20例患者,30mmHg<sPAP<50mmHg(1mmHg=0.133kPa),B组20例患者,50mmHg≤sPAP<70mmHg,C组18例患者,sPAP≥70mmHg。所有患者经手术完全矫治心脏畸形。手术前后测量sPAP及6MWT。术后记录机械通气时间、ICU停留时间。结果:全组手术无死亡。手术前A、B及C组的sPAP分别为(33.3±7.1)mmHg、(58.6±12.1)mmHg及(73.6±12.5)mmHg;手术后3组的sPAP分别为(25.5±5.8)mmHg、(38.8±12.5)mmHg及(64.8±11.5)mmHg;与手术前相比3组sPAP均明显下降,P<0.05。手术前A、B及C组的6MWT分别为(420.2±33.3)m、(354.2±48.3)m及(320.2±41.3)m;手术后3组的6MWT分别为(440.8±22.5)m、(400.8±35.7)m及(340.2±38.2)m;与术前相比3组均明显提高,P<0.05,B组手术后6MWT提高最明显,P<0.01。A、B及C组术后机械通气时间分别为(4.2±2.3)h、(8.6±4.3)h及(14.2±6.6)h;术后ICU停留时间分别为(1.0±0.4)d,(2.1±1.1)d及(5.3±2.1)d。组间比较C组的机械通气时间、ICU停留时间明显较A、B组为长。结论:心脏手术前后重复6MWT能够评价合并肺动脉高压的先心病患者运动能力改善情况,评估手术效果。展开更多
文摘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 integrate 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. Combining the BILL strategy with CCE can enhance comprehensive understanding of critical conditions, potentially leading to improved diagnostic accuracy and patient outcomes.
