PiCCO之容量反应性.pptx

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1、PiCCO之容量反应性监测顺德第一人民医院重症医学科陈德珠组织器官灌注指标UrineoutputMentationCapillaryrefillSkinperfusion/mottling……BloodlactateArterialpH,BE,HCO3SvO2orScvO2MixedvenouspCO2……血流动力学监测COMAPSVR=xSVHRxAfterloadPreloadCardiaccontractilityHypovolemia液体复苏的顾虑HypervolemiaTissuehypoperfusionWorsenorga

2、ndysfunc-tionImpedeoxygendeliveryCompromisepatientout-come容量反应性COMAPSVR=xSVHRxAfterloadPreloadCardiaccontractility心肺交互作用PiCCO之容量反应性监测指标StrokeVolumeVariation（SVV）PulsePressureVariation（PPV）PPV、SVV的临床应用20patientsundergoingelectivecoronaryarterybypassgrafting.6%hydroxyethyl

3、starch200/0.5(7mL/kg)witharateof1mL/kg/min.PPV、SVV的临床应用PPV、SVV的临床应用PPV、SVV的临床应用PPV、SVV的临床应用PPV、SVV的临床应用PPV、SVV的临床应用PPV、SVV的临床应用PPV、SVV的临床应用PPV、SVV的临床应用PPV、SVV的临床应用PPV、SVV的临床应用PPV、SVV的局限性ArrhythmiasspontaneousbreathingactivityMechanicalventilation(Vt,PEEP)Severerightventr

4、iculardysfunctionVasoactiveagentGreyZone(9%and13%)PPV、SVV的局限性PPV、SVV的局限性PPV、SVV的局限性PPV、SVV的局限性PPV、SVV的局限性PPV、SVV的局限性PPV、SVV的局限性PPV、SVV的局限性结语ContinuousmonitoringDynamicmonitoringDataintegration