（优质医学）危重患者的血流动力学监测.pptVIP

VO2 DO2 SvO2 Optimal EO2 = ? Optimal EO2 = 30% Optimal EO2 = 40% SvO2 indicator of the VO2/DO2 balance Critical DO2 EO2 * 血乳酸范围 重症患者乳酸正常值 2mmol/l 高乳酸血症 定义为2 – 5 mmol/l 乳酸性酸中毒 5mmol/l伴有代谢性酸中毒 * 乳酸性酸中毒的原因及分类 代谢紊乱 组织缺氧 药物、毒素或先天性疾病导致的糖代谢异常 Cohen and Woods Type A poor tissue perfusion Type B no clinical evidence of poor tissue perfusion * 早期乳酸清除率 从初始发现到６hr乳酸下降的百分比 119pts with severe sepsis or septic shock Survivors nonsurvivors 38.1 ± 34.6 vs. 12.0 ± 51.6% (p = .005) 乳酸清除率明显与预后负相关 (p = .04) Crit