组织灌注的床旁评价的最新进展课件.pptVIP

组织灌注床旁评价的最新进展;传统复苏目标;Normal Circulation;Hemodynamic Shock (Drug therapy);Oxygen Delivery;Oxygen Demand;氧摄取率;;复苏治疗目标;复苏的核心目标是 如何解决氧的供需矛盾问题;;; Pain Hyperthermia;SvO2 监测;Pathophysiologyof SVO2 and ScVO2;提高SvO2的措施;SvO2 监测;n n n n;Early lactate clearance is associated with improved outcome in severe sepsis and septic shock;Multivariate logistic regression modeling;11% decrease in likelihood of mortality for each 10% increase in lactate clearance;复苏终点与预后评估指标;; P(cv-a) CO2：a useful tool n central venous-to-arterial carbon dioxide difference，may serve as a global index of tissue perfusion when the central venous oxygen saturation (ScvO2) goal value has already been reached;P (cv-a)CO2：a useful tool;n; ScvO2 Pcv-aCO2 SOFA;P(cv-a)CO2: a useful tool;P(cv-a)CO2;Phi、胃粘膜CO2(mucosal PCO2)、△PCO2 (mucosal/arterial CO2 gradient)反映局部组织灌注的指标;CO2 + H2O H+ + HCO3-;;regional intestinal capnography;gastric intramucosal pCO2 and sublingual pCO2 胃粘膜和舌下PCO2;组织氧张力;组织氧张力;舌下正交偏振广谱 (OPS);舌下正交偏振广谱 (OPS);? de Backer 等在脓毒症患者运用OPS监测;OPS ——微循环从理论走向实践; OPS ——微循环从理论走向实践 MAP在65mmHg、75mmHg、85mmHg时;旁流暗场成像(SDF);(a) (b);休克治疗的最终目标是 维持组织灌注和细胞氧合！;n;谢谢 !