What’s new in hemorrhagic shock?
What’s new in hemorrhagic shock?
复制标题
失血性休克有何新进展？
DOI：
10.1007/s00134-015-3658-8
复制
发表时间：
2015
影响因子：
38.9
通讯作者：
Z. Molnár
中科院分区：
文献类型：
--
作者：
K. Tánczos;M. Németh;Z. Molnár
失血性休克是一种危及生命的疾病，需要立即采取一系列干预措施。尽管一些细节仍有争议，但已经取得了一些重要的成就，有很大潜力影响这些患者的护理和结果。失血性休克的识别应结合临床、血流动力学和生化体征。低血压不应成为休克诊断的先决条件，应考虑通过彻底检查皮肤灌注、尿量和精神状态改变来评估组织灌注不足，以及无氧代谢的实验室症状，如血清乳酸和代谢性酸中毒[1]。失血性休克治疗的主要目标包括纠正氧输送（DO2）和消耗（VO2）之间的不平衡、维持足够的灌注压以及预防或治疗凝血障碍（图1）[2]。
Hemorrhagic shock is a life-threatening condition requiring a series of immediate interventions. Although several details are still debated, there have been some important achievements with great potential to influence the care and outcomes of these patients. The recognition of hemorrhagic shock should be based on a combination of clinical, hemodynamic and biochemical signs. The presence of low blood pressure should not be a prerequisite of shock diagnosis, and assessment of inadequate tissue perfusion by thorough examination of cutaneous perfusion, urine output and altered mental status together with laboratory signs of anaerobic metabolism such as serum lactate and metabolic acidosis should all be taken into account [1]. The main goals of the treatment of hemorrhagic shock include the correction of the imbalance between oxygen delivery (DO2) and consumption (VO2), maintaining adequate perfusion pressure, and preventing or treating coagulopathy (Fig. 1)[2].