CHỌN LỰA PHƯƠNG PHÁP THEO DÕI HUYẾT ĐỘNG THÍCH HỢP CHO NGƯỜI BỆNH SỐC TUẦN HOÀN

Abstract

Critically ill patients are commonly hemodynamically unstable due to volume depletion, cardiac dysfunction, or altered vasomotor function, causing organ dysfunction, progression to multi-organ failure, and ultimately death. Appropriate hemodynamic monitoring helps guide therapy to prevent or treat organ failure and improve patient outcomes. Over the past decades, hemodynamic monitoring techniques have evolved toward less invasiveness as well as continuous and real-time measurements. Currently, echocardiography is the first-line modality for hemodynamic evaluation in patients with shock and should be performed early to assess cardiac structure and function. Cardiac output monitoring and advanced hemodynamic monitoring are only recommended in patients with shock unresponsive to initial therapy and/or in the most complex patients. The pulmonary artery catheter is recommended in patients with refractory shock associated with a right ventricular dysfunction. Transpulmonary thermodilution devices are recommended in patients with severe shock associated with acute respiratory distress syndrome.