BILL Strategy:Points to Consider During the Performance and Interpretation of Critical Care Echocardiography  

BILL策略:重症心脏超声操作及解读中需要注意的问题

作　　者：Hong-Min Zhang Hui Lian Xiao-Ting Wang 张宏民;廉慧;王小亭(保健医疗部,北京协和医院,中国医学科学院北京协和医学院,北京100730;重症医学科,北京协和医院,中国医学科学院北京协和医学院,北京100730)

机构地区：[1]Department of Health Care,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing,100730 China [2]Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College,Beijing,100730 China

出　　处：《Chinese Medical Sciences Journal》2024年第3期234-241,共8页中国医学科学杂志（英文版）

基　　金：北京重症超声研究会临床科研专项基金(2022-CCUSG-A-01);中央高水平医院临床科研专项专科提升项目(2022-PUMCH-B-026)。

摘　　要：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.为保证重症心脏超声的准确应用,临床医生在操作前和操作过程中需要对重症病人的临床情况进行精细解读,从而减少对重要超声信息的忽略或错误解读。本文提供了一个“BILL”策略以更好地完成重症心脏超声的过程,其中“B”指的是呼吸、循环的基线支持条件;“I”指的是通过有创监测获得的信息,包括中心静脉压以及热稀释法获得的心输出量等指标;第一个“L”指的是化验指标,包括中心静脉血氧饱和度、肌钙蛋白、脑钠肽等;第二个“L”指的是肺部超声信息。“BILL”策略与重症心脏超声的结合有助于更好地理解重症状态,提高诊断准确性并进而改善重症患者的结局。

关 键 词：ECHOCARDIOGRAPHY critical care clinical condition 

分 类 号：R540.45[医药卫生—心血管疾病]