1、P PI ICCOCCO 之之容量反应性监测容量反应性监测顺德第一人民医院重症医学科顺德第一人民医院重症医学科陈德珠陈德珠组织器官灌注指标Urine outputMentationCapillary refillSkin perfusion/mottlingBlood lactateArterial pH, BE, HCO3SvO2 or ScvO2Mixed venous pCO2血流动力学监测COMAPSVR=xSVHRxAfterloadPreloadCardiac contractility Hypovolemiaypovolemia液体复苏的顾虑HHypervolemiaypervo
2、lemiaTissue hypoperfusionWorsen organ dysfunc-tionImpede oxygen deliveryCompromise patient out-come容量反应性COMAPSVR=xSVHRxAfterloadPreloadCardiac contractility心肺交互作用PICCO之容量反应性监测指标Stroke Volume Variation（SVV） Pulse Pressure Variation（PPV）PPV、SVV的临床应用20 patients undergoing elective coronary artery bypas
3、s grafting. 6% hydroxyethyl starch 200/0.5 (7mL/ kg) with a rate of 1mL /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Arrhythmiasspontaneous breathing activity Mechanical ventilation (Vt, PEEP)Severe right ventricular dysfunctionVasoactive agent Grey Zone (9% and 13% )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Continuous monitoringDynamic monitoringData integration
