重症血流动力学监测技术应用规范

Standards for the Application of Hemodynamic Monitoring Technology in Critical Care

  • 摘要: 随着血流动力学指标和监测技术的迅速发展,其分类方法与应用流程日益复杂,目前尚未形成统一规范,难以充分满足临床重症血流动力学的治疗需求。为协助重症血流动力学的监测评估与治疗决策,重症血流动力学治疗协作组联合重症超声研究组共同制定了《重症血流动力学监测技术应用规范》,本规范第一部分对血流动力学指标进行了系统化分类,将其划分为流量指标、压力及其衍生指标和组织灌注指标,并阐述了各项指标的临床应用。第二部分构建了血流动力学监测的规范化临床实施路径,针对不同临床场景,提出基础监测、进阶监测、适应证监测和特殊场景监测的阶梯化方案,强调重症超声在各层级监测中的核心地位,并建立颅脑、肾脏、胃肠道等器官的血流动力学评估标准。本规范旨在为重症医学科临床实践、教学培训及科研工作提供统一标准,推动学科规范化发展。

     

    Abstract: With the rapid advancement of hemodynamic indices and monitoring technologies, their classification methods and application processes have become increasingly complex. To date, no unified standard has been established, making it difficult to fully meet the needs of clinical critical care hemodynamic management. To assist in hemodynamic monitoring assessment and therapeutic decision-making in critically ill patients, the Critical Hemodynamic Therapy Collaborative Group and the Critical Ultrasound Study Group jointly formulated the Clinical Application Standard for Hemodynamic Monitoring in Critical Care. In Part 1, the document systematically classifies hemodynamic indices into three categories:flow-related indices, pressure-related and derived indices, and tissue perfusion indices, while elaborating on the clinical application of each. Part 2 establishes a standardized clinical implementation pathway for hemodynamic monitoring, proposing a tiered approach-including basic, advanced, indication-specific, and special-scenario monitoring-tailored to different clinical contexts. It emphasizes the central role of critical ultrasound at all monitoring levels and sets hemodynamic assessment criteria for organs such as the brain, kidneys, and gastrointestinal tract. This standard aims to provide a unified framework for clinical practice, teaching, training, and research in critical care medicine, thereby promoting standardized development within the discipline.

     

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