• 1 北京大學(xué)第三醫(yī)院危重醫(yī)學(xué)科(北京 100083);;
  • 2 北京大學(xué)第一醫(yī)院心臟外科;

血流動(dòng)力學(xué)監(jiān)測(cè)是了解患者循環(huán)功能狀態(tài),指導(dǎo)制定治療方案的重要依據(jù),也是危重癥醫(yī)學(xué)領(lǐng)域的重要內(nèi)容。以往臨床上最常用的血流動(dòng)力學(xué)指標(biāo)是一些靜態(tài)的、壓力性的指標(biāo),如中心靜脈壓(CVP)、肺動(dòng)脈楔壓(PAOP)。但已有大量研究資料證實(shí)用靜態(tài)的壓力指標(biāo)來(lái)反映循環(huán)系統(tǒng)的前負(fù)荷情況并不十分理想[1,2],因而一些新的能更全面準(zhǔn)確地評(píng)價(jià)循環(huán)容量的指標(biāo)引起了臨床工作者的重視。

引用本文: 汪宗昱 ,吳勝楠,朱曦,伊敏,李宏亮. 功能性血流動(dòng)力學(xué)監(jiān)測(cè). 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2008, 08(3): 237-240. doi: 復(fù)制

1. Nouira S,Elatrous S,Dimassi S,et al.Effects of norepinephrine on static and dynamic preload indicators in experimental hemorrhagic shock.Crit Care Med,2005,33:2339-2343.
2. Wiesenack C,Prasser C,Keyl C,et al.Assessment of intrathoracic blood volume as an indicator of cardiac preload:single transpulmonary thermodilution technique versus assessment of pressure preload parameters derived from a pulmonary artery catheter.J Cardiothorac Vasc Anesth,2001,15:584-588.
3. Della Rocca G,Costa GM,Coccia C,et al.Preload index:pulmonary artery occlusion pressure versus intrathoracic blood volume monitoring during lung transplantation.Anesth Analg,2002,95:835-843.
4. Vignon P.Hemodynamic assessment of critically ill patients using echocardiography Doppler.Curr Opin Crit Care,2005,11:227-234.
5. Pinsky MR.Functional hemodynamic monitoring.Intensive Care Med,2002,28,386-388.
6. Berkenstadt H,Margalit N,Hadani M,et al.Stroke volume variation as a predictor of fluid responsiveness in patients undergoing brain surgery.Anesth Analg,2001,92:984-989.
7. Michard F,Boussat S,Chemla D,et al.Relation between respiratory changes in arterial pulse pressure and fluid responsiveness in septic patients with acute circulatory failure.Am J Respir Crit Care Med,2000,162:134-138.
8. Marx G,Cope T,McCrossan L,et al.Assessing fluid responsiveness by stroke volume variation in mechanically ventilated patients with severe sepsis.Eur J Anaesthesiol,2004,21:132-138.
9. Kramer A,Zygun D,Hawes H,et al.Pulse pressure variation predicts fluid responsiveness following coronary artery bypass surgery.Chest,2004,126:1563-1568.
10. Michard F,Teboul JL.Predicting fluid responsiveness in ICU patients:a critical analysis of the evidence.Chest,2002,121:2000-2008.
11. Preisman S,Kogan S,Berkenstadt H,et al.Predicting fluid responsiveness in patients undergoing cardiac surgery:functional haemodynamic parameters including the respiratory systolic variation test and static preload indicators.Br J Anaesth,2005,95:746-755.
12. Hofer CK,Müller SM,F(xiàn)urrer L,et al.Stroke volume and pulse pressure variation for prediction of fluid responsiveness in patients undergoing off-pump coronary artery bypass grafting.Chest,2005,128:848-854.
13. Rex1 S,Brose S,Metzelder S,et al.Prediction of fluid responsiveness in patients during cardiac surgery.Br J Anaesth,2004,93:782-788.
14. Wiesenack C,F(xiàn)iegl C,Keyser A,et al.Assessment of fluid responsiveness in mechanically ventilated cardiac surgical patients.Eur J Anaesthesiol,2005,22:658-665.
15. Fujita Y,Yamamoto T,Sano I,et al.A comparison of changes in cardiac preload variables during graded hypovolemia and hypervolemia in mechanically ventilated dogs.Anesth Analg,2004,99:1780-1786.
16. Vieillard-Baron A,Chergui K,Rabiller A,et al.Superior vena cava collapsibility as a gauge of volume status in ventilated septic patients.Intensive Care Med,2004,30:1734-1739.
17. Feissel M,Michard F,F(xiàn)aller JP,et al.The respiratory variation in inferior vena cava diameter as a guide to fluid therapy.Intensive Care Med,2004,30:1834-1837.
18. Barbier C,Loubières Y,Schmit C,et al.Respiratory changes in inferior vena cava diameter are helpful in predicting fluid responsiveness in ventilated septic patients.Intensive Care Med,2004,30:1740-1746.
19. Feissel M,Michard F,Mangin I,et al.Respiratory changes in aortic blood velocity as an indicator of fluid responsiveness in ventilated patients with septic shock.Chest,2001,119:867-873.
20. Bendjelid K,Suter PM,Romand JA.The respiratory change in preejection period:a new method to predict fluid responsiveness.J Appl Physiol,2004,96:337-342.
21. Wyffels PA,Durnez PJ,Helderweirt J,et al.Ventilation-induced plethysmographic variations predict fluid responsiveness in ventilated postoperative cardiac surgery patients.Anesth Analg,2007,105:448-452.
22. Reuter DA,F(xiàn)elbinger TW,Schmidt C,et al.Storke volume variations for assessment of cardiac responsiveness to volume loading in mechanically ventilated patients after cardiac surgery.Intensive Care Med,2002,28:392-398.
23. Perner A,F(xiàn)aber T.Stroke volume variation does not predict fluid responsiveness in patients with septic shock on pressure support ventilation.Acta Anaesthesiol Scand,2006,50:1068-1073.
24. Heenen S,De Backer D,Vincent JL.How can the response to volume expansion in patients with spontaneous respiratory movements be predicted? Crit Care,2006,10:R102.
25. Reuter DA,Bayerlein J,Goepfert MS,et al.Influence of tidal volume on left ventricular stroke volume variation measured by pulse contour analysis in mechanically ventilated patients.Intensive Care Med,2003,29:476-480.
26. Backer DD,Heenen S,Piagnerelli M,et al.Pulse pressure variations to predict fluid responsiveness:influence of tidal volume.Intensive Care Med,2005,31:517-523.
27. Renner J,Cavus E,Meybohm P,et al.Stroke volume variation during hemorrhage and after fluid loading:impact of different tidal volumes.Acta Anaesthesiol Scand,2007,51:538-544.
  1. 1. Nouira S,Elatrous S,Dimassi S,et al.Effects of norepinephrine on static and dynamic preload indicators in experimental hemorrhagic shock.Crit Care Med,2005,33:2339-2343.
  2. 2. Wiesenack C,Prasser C,Keyl C,et al.Assessment of intrathoracic blood volume as an indicator of cardiac preload:single transpulmonary thermodilution technique versus assessment of pressure preload parameters derived from a pulmonary artery catheter.J Cardiothorac Vasc Anesth,2001,15:584-588.
  3. 3. Della Rocca G,Costa GM,Coccia C,et al.Preload index:pulmonary artery occlusion pressure versus intrathoracic blood volume monitoring during lung transplantation.Anesth Analg,2002,95:835-843.
  4. 4. Vignon P.Hemodynamic assessment of critically ill patients using echocardiography Doppler.Curr Opin Crit Care,2005,11:227-234.
  5. 5. Pinsky MR.Functional hemodynamic monitoring.Intensive Care Med,2002,28,386-388.
  6. 6. Berkenstadt H,Margalit N,Hadani M,et al.Stroke volume variation as a predictor of fluid responsiveness in patients undergoing brain surgery.Anesth Analg,2001,92:984-989.
  7. 7. Michard F,Boussat S,Chemla D,et al.Relation between respiratory changes in arterial pulse pressure and fluid responsiveness in septic patients with acute circulatory failure.Am J Respir Crit Care Med,2000,162:134-138.
  8. 8. Marx G,Cope T,McCrossan L,et al.Assessing fluid responsiveness by stroke volume variation in mechanically ventilated patients with severe sepsis.Eur J Anaesthesiol,2004,21:132-138.
  9. 9. Kramer A,Zygun D,Hawes H,et al.Pulse pressure variation predicts fluid responsiveness following coronary artery bypass surgery.Chest,2004,126:1563-1568.
  10. 10. Michard F,Teboul JL.Predicting fluid responsiveness in ICU patients:a critical analysis of the evidence.Chest,2002,121:2000-2008.
  11. 11. Preisman S,Kogan S,Berkenstadt H,et al.Predicting fluid responsiveness in patients undergoing cardiac surgery:functional haemodynamic parameters including the respiratory systolic variation test and static preload indicators.Br J Anaesth,2005,95:746-755.
  12. 12. Hofer CK,Müller SM,F(xiàn)urrer L,et al.Stroke volume and pulse pressure variation for prediction of fluid responsiveness in patients undergoing off-pump coronary artery bypass grafting.Chest,2005,128:848-854.
  13. 13. Rex1 S,Brose S,Metzelder S,et al.Prediction of fluid responsiveness in patients during cardiac surgery.Br J Anaesth,2004,93:782-788.
  14. 14. Wiesenack C,F(xiàn)iegl C,Keyser A,et al.Assessment of fluid responsiveness in mechanically ventilated cardiac surgical patients.Eur J Anaesthesiol,2005,22:658-665.
  15. 15. Fujita Y,Yamamoto T,Sano I,et al.A comparison of changes in cardiac preload variables during graded hypovolemia and hypervolemia in mechanically ventilated dogs.Anesth Analg,2004,99:1780-1786.
  16. 16. Vieillard-Baron A,Chergui K,Rabiller A,et al.Superior vena cava collapsibility as a gauge of volume status in ventilated septic patients.Intensive Care Med,2004,30:1734-1739.
  17. 17. Feissel M,Michard F,F(xiàn)aller JP,et al.The respiratory variation in inferior vena cava diameter as a guide to fluid therapy.Intensive Care Med,2004,30:1834-1837.
  18. 18. Barbier C,Loubières Y,Schmit C,et al.Respiratory changes in inferior vena cava diameter are helpful in predicting fluid responsiveness in ventilated septic patients.Intensive Care Med,2004,30:1740-1746.
  19. 19. Feissel M,Michard F,Mangin I,et al.Respiratory changes in aortic blood velocity as an indicator of fluid responsiveness in ventilated patients with septic shock.Chest,2001,119:867-873.
  20. 20. Bendjelid K,Suter PM,Romand JA.The respiratory change in preejection period:a new method to predict fluid responsiveness.J Appl Physiol,2004,96:337-342.
  21. 21. Wyffels PA,Durnez PJ,Helderweirt J,et al.Ventilation-induced plethysmographic variations predict fluid responsiveness in ventilated postoperative cardiac surgery patients.Anesth Analg,2007,105:448-452.
  22. 22. Reuter DA,F(xiàn)elbinger TW,Schmidt C,et al.Storke volume variations for assessment of cardiac responsiveness to volume loading in mechanically ventilated patients after cardiac surgery.Intensive Care Med,2002,28:392-398.
  23. 23. Perner A,F(xiàn)aber T.Stroke volume variation does not predict fluid responsiveness in patients with septic shock on pressure support ventilation.Acta Anaesthesiol Scand,2006,50:1068-1073.
  24. 24. Heenen S,De Backer D,Vincent JL.How can the response to volume expansion in patients with spontaneous respiratory movements be predicted? Crit Care,2006,10:R102.
  25. 25. Reuter DA,Bayerlein J,Goepfert MS,et al.Influence of tidal volume on left ventricular stroke volume variation measured by pulse contour analysis in mechanically ventilated patients.Intensive Care Med,2003,29:476-480.
  26. 26. Backer DD,Heenen S,Piagnerelli M,et al.Pulse pressure variations to predict fluid responsiveness:influence of tidal volume.Intensive Care Med,2005,31:517-523.
  27. 27. Renner J,Cavus E,Meybohm P,et al.Stroke volume variation during hemorrhage and after fluid loading:impact of different tidal volumes.Acta Anaesthesiol Scand,2007,51:538-544.
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