THE ROLE OF CENTRAL VENOUS OXIMETRY, LACTIC-ACID CONCENTRATION AND SHOCK INDEX IN THE EVALUATION OF CLINICAL SHOCK - A REVIEW

被引：44

作者：

RADY, MY

机构：

[1] Department of Emergency Medicine, Henry Ford Hospital, Detroit, MI 48202

来源：

RESUSCITATION | 1992年 / 24卷 / 01期

关键词：

SHOCK; CENTRAL VENOUS OXIMETRY; LACTIC ACID CONCENTRATION; SYSTEMIC OXYGENATION; SHOCK INDEX;

D O I：

10.1016/0300-9572(92)90173-A

中图分类号：

R4 [临床医学];

学科分类号：

1002 [临床医学]; 100602 [中西医结合临床];

摘要：

Initial therapy of shock in the emergency department emphasizes the normalization of hemodynamic variables e.g. heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP) rather than optimization of systemic and regional oxgenation. Central venous oximetry (SCVO2), arterial lactic acid concentrations (Lact) and the shock index (SI) were examined during initial hemodynamic stabilization of clinical shock in the emergency room. Although initial therapy normalized MAP, CVP and HR; SCVO2, Lact and SI continued to be abnormal indicating inadequate systemic oxygenation and left ventricular (LV) performance. Measurement of SCVO2, Lact and SI may provide valuable additonal information on the adequacy of systemic oxygenation and LV function during initial therapy of shock. This may identify patients who require further monitoring and intervention to optimize systemic oxygen transport and cardiac performance and reduce their morbidity and mortality.

引用

页码：55 / 60

页数：6

共 34 条

[1]

Baek, Makabali, Bryan-Brown, Et al., Plasma expansion in surgical patients with high central venous pressure (CVP)

[2]

the relationship of blood volume to hematocrit, CVP, pulmonary wedge pressure and cardiorespiratory changes, Surgery, 78, pp. 304-315, (1975)

[3]

Shoemaker, Appel, Bland, Et al., Clinical trial of an algorithm for outcome prediction in acute circulatory failure, Crit Care Med, 10, pp. 390-397, (1982)

[4]

Bland, Shoemaker, Abraham, Et al., Haemodynamic and oxygen transport patterns in surviving and nonsurviving postoperative patients, Crit Care Med, 13, pp. 85-90, (1985)

[5]

Shoemaker, Relationship of oxygen transport patterns to the pathophysiology and therapy of shock states, Int Care Med, 13, pp. 230-243, (1987)

[6]

Shoemaker, Appel, Waxman, Et al., Clinical trial of survivors' cardiorespiratory patterns as therapeutic goals in critically ill postoperative patients, Crit Care Med, 10, pp. 398-403, (1982)

[7]

Shoemaker, Appel, Kram, Et al., Prospective trial of supranormal values of survivors as therapeutic goals in high risk surgical patients, Chest, 94, pp. 1176-1186, (1988)

[8]

Shoemaker, Appel, Kram, Tissue oxygen debt as a determinant of lethal and nonlethal postoperative organ failure, Critical Care Medicine, 16, pp. 1117-1120, (1988)

[9]

Siegel, Pearl, Noninvasive cardiac output measurment: troubled technologies and troubled studies, Anesth Analg, 74, pp. 790-792, (1992)

[10]

Sturm, Lewis, Trentz, Et al., Cardiopulmonary parameters and prognosis after severe multiple trauma, The Journal of Trauma: Injury, Infection, and Critical Care, 19, pp. 305-318, (1979)

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