肺保护性通气患者容量反应性评估的研究进展  

Research progress in the evaluation of fluid responsiveness in patients with lung-protective ventilation

作　　者：罗超 高巨 LUO Chao;GAO Ju(Department of Anesthesiology,Clinical Medical School of Yangzhou University,Northern Jiangsu People's Hospital,Yangzhou 225001,China)

机构地区：[1]扬州大学临床医学院,江苏省苏北人民医院麻醉科,225001

出　　处：《临床麻醉学杂志》2022年第2期203-206,共4页Journal of Clinical Anesthesiology

基　　金：国家自然科学基金(81571936)。

摘　　要：传统静态指标不能准确评估机械通气患者的容量反应性。目前,基于心-肺交互机制的动态指标如脉压变异度(PPV)和每搏量变异度(SVV)等是预测机械通气患者容量反应性的金标准,但上述指标容易受潮气量影响,不能准确预测肺保护性通气(潮气量<8 ml/kg)患者的容量反应性。近年来,随着对心-肺交互机制的深入研究以及重症超声技术的飞速发展,血流动力学试验联合动态指标有望为评估肺保护性通气患者的容量反应性开辟新的前景。全文主要就心-肺交互机制的血流动力学研究以及心脏超声技术评估肺保护性通气患者容量反应性的最新进展作一综述,以期为临床医师评估此类患者的容量反应性提供参考。Traditional static indicators can not accurately evaluate the fluid responsiveness of patients with mechanical ventilation,while dynamic indicators based on the mechanism of heart-lung interaction,such as pulse pressure variation and stroke volume variation are regarded as the gold standard for predicting the fluid responsiveness of patients with mechanical ventilation at present,but these indicators are easily affected by the tidal volume and can t accurately predict the fluid responsiveness of patients with lung protective ventilation.In recent years,with the in-depth study of the mechanism of heart-lung interaction and the rapid development of critical care ultrasonography,hemodynamic test combined with dynamic indicators are expected to open up a new prospect for evaluating the fluid responsiveness of patients with lung protective ventilation.This article mainly focuses on the hemodynamic study of the mechanism of heart-lung interaction and the latest progress in evaluating the fluid responsiveness of patients with lung protective ventilation by echocardiography,in order to provide clinical theoretical basis for clinicians to evaluate the fluid responsiveness of patients.

关 键 词：肺保护性通气 容量反应性 心-肺交互 超声 

分 类 号：R614[医药卫生—麻醉学]