Monitoring of standard hemodynamic parameters: Heart rate, systemic blood pressure, atrial pressure, pulse oximetry, and end-tidal CO2
Monitoring of standard hemodynamic parameters: Heart rate, systemic blood pressure, atrial pressure, pulse oximetry, and end-tidal CO2
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DOI：
10.1097/pcc.0b013e318220e7ea
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发表时间：
2011-07-01
影响因子：
4.1
通讯作者：
Bohn, Desmond
中科院分区：
文献类型：
--
作者：
Ben Sivarajan, V.;Bohn, Desmond
背景资料：在儿科重症监护医学中，对血流动力学和呼吸状态的各种临床参数进行连续监测已成为常规。支持这些做法的证据是检查在此review.Methodology：检索MEDLINE，EMBASE，PubMed和科克伦数据库进行对照试验的心率，心电图，无创和有创血压，心房压力，潮气末二氧化碳和脉搏血氧监测。考虑了成人和儿童数据。对重症监护医学会、美国心脏协会、美国儿科学会和国际复苏联络委员会发表的指南进行了回顾，包括对引用文献的进一步回顾。结果和结论：使用心率、心电图、无创血压和动脉血压、心房压、脉搏血氧饱和度，在儿科重症监护室中，呼气末二氧化碳监测是常见的;然而，这种做法没有得到良好控制的临床试验的支持。尽管大多数文献是病例系列，但专家意见认为，使用常规脉搏血氧饱和度和呼气末二氧化碳是当前的标准治疗。此外，文献表明，有创动脉监测是休克情况下监测的当前标准。使用心率、心电图。心房压力监测在特定的临床情况下（心脏手术后）是有利的;然而，这方面的证据仅基于大量病例系列。（Pediatr Crit Care Med 2011; 12[Suppl.]：S2-S11）
Background: Continuous monitoring of various clinical parameters of hemodynamic and respiratory status in pediatric critical care medicine has become routine. The evidence supporting these practices is examined in this review.Methodology: A search of MEDLINE, EMBASE, PubMed, and the Cochrane Database was conducted to find controlled trials of heart rate, electrocardiography, noninvasive and invasive blood pressure, atrial pressure, end-tidal carbon dioxide, and pulse oximetry monitoring. Adult and pediatric data were considered. Guidelines published by the Society for Critical Care Medicine, the American Heart Association, the American Academy of Pediatrics, and the International Liaison Committee on Resuscitation were reviewed, including further review of references cited.Results and Conclusions: Use of heart rate, electrocardiography, noninvasive and arterial blood pressure, atrial pressure, pulse oximetry, and end-tidal carbon dioxide monitoring in the pediatric critical care unit is commonplace; this practice, however, is not supported by well-controlled clinical trials. Despite the majority of literature being case series, expert opinion would suggest that use of routine pulse oximetry and end-tidal carbon dioxide is the current standard of care. In addition, literature would suggest that invasive arterial monitoring is the current standard for monitoring in the setting of shock. The use of heart rate, electrocardiography. and atrial pressure monitoring is advantageous in specific clinical scenarios (postoperative cardiac surgery); however, the evidence for this is based on numerous case series only. (Pediatr Crit Care Med 2011; 12[Suppl.]:S2-S11)