休克复苏:血流至上,氧流至优  

In Shock Resuscitation,Blood Flow Should be Considered First,and Oxygen Flux Should be Optimized Second

作　　者：杜微 王小亭 刘大为 DU Wei;WANG Xiaoting;LIU Dawei(Department of Intensive Care Unit,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院重症医学科,北京100730

出　　处：《协和医学杂志》2022年第6期915-920,共6页Medical Journal of Peking Union Medical College Hospital

基　　金：中国医学科学院中央级公益性研究院所基本科研业务费专项资金(2020-RW320-001)。

摘　　要：人类对重症认知的重要里程碑是从对休克的血流动力学精细化理解开始。经过几十年的发展,血流动力学治疗理念更加完善,休克的治疗既有依托于指南的群体化治疗,又有具体到床旁每一位患者的个体化策略。血流的龙头效应早已深入人心,而血流中的氧流更是休克血流动力学复苏的目的性指标。本文对血流及血流中的氧流进行进一步追踪探讨,并将血流与氧流的影响因素、监测与复苏导向治疗进行拆分,提出基于血流-氧流的休克新分型,以期在器官化血流动力学治疗理念之下开启更精准的血流动力学治疗时代。An important milestone in human cognition of severe diseases began with a refined understanding of the hemodynamics of shock.After decades of development,the concept of hemodynamic therapy has become more perfect.The treatment of shock involves not only guided group therapy,but also bedside individualized strategies.The leading effect of blood flow has long been well understood,and the oxygen flux in the blood flow is the target index of hemodynamic resuscitation of shock.In this paper,we aim to further explore blood flow and blood oxygen flux,separate the influence factors of blood flow and oxygen flux,monitoring and recovery-guided treatment,and propose four subtypes based on blood flow and oxygen flux shock,with the hope of ushering in an era of more precise hemodynamic treatment for organ hemodynamic therapy.

关 键 词：休克 血流动力学 血流 氧流 复苏 

分 类 号：R441.9[医药卫生—诊断学]