关于脓毒症的事实

对及时干预来说,及早发现至关重要。1

为早期评价和干预提供清楚明确的数据,助您在脓毒症的防治上始终保持主动。6

脓毒症管理有时效性。7、8患者尽早得到诊断并接受合适的重症监护极其重要。

脓毒症患者可表现出多样的血液动力学特性。 在确定容量反应性时,间歇式地监测关键而迅速变化的患者参数不能提供充足的信息。

在每一刻都很重要的情况下,先进的基于流量的动态数据访问为您提供宝贵的信息,为积极的容量管理决策提供指南。6

Edwards Lifesciences高级血液动力学监测解决方案帮助您早期发现脓毒症症状,为治疗评价提供指南,以及遵循CMS/NQF集束治疗指南。6、10-12

脓毒症集束治疗指南概况>现在查看

血液动力学监测解决方案

血液动力学监测解决方案帮助对患者个别进行评价,并且满足
CMS 指南的要求6、10-12

Edwards 提供先进的血液动力学监测解决方案,临床医师可根据每个患者的生理学需求进行调整,有助于对脓毒症、严重脓毒症和脓毒性休克进行积极管理。6

指套式传感器

无创ClearSight指套式传感器

SV、SVV、SVR、CO、cBP

ClearSight指套式传感器可用来在3小时 CMS脓毒症集束治疗的液体管理部分之前、之中和之后连续测量基于流量的参数。 ClearSight指套式传感器可快速无创连接到广泛的患者人群,包括老年人与肥胖者。9、13-14在给非机械通气患者进行液体冲击(fluid challenge)和被动抬腿试验时,可用于测试对液体的反应性。 连续血压、CO和SV可提供前负荷敏感变化信息,为采取措施提供依据。

FloTrac

微创FloTrac传感器

SVV、SVR、CCO

FloTrac系统可用来在3小时 CMS脓毒症集束治疗的液体管理部分之前、之中和之后连续测量基于流量的参数。 FloTrac系统是微创器械,可连接到任何已有的动脉导管,在患者敏感度变化时升级连续监测水平。 CO和SV的连续监测9提供前负荷敏感变化信息,为采取措施提供依据。

血氧监测

Edwards中心静脉血氧饱和度导管套件(EOCVC)

Edwards 中心静脉血氧饱和度导管符合CMS推荐的给予血管加压药时放置中心静脉导管的核心措施。15-16利用连续测量ScvO 2和CVP的Edwards 中心静脉血氧饱和度导管,仅一个耗材就能满足再评估要求。 Edwards 中心静脉血氧饱和度导管连续监测ScvO2,这是氧供不足或受损的早期指标,而且已证明能够比单独依靠生命体征更早地揭示关键变化,让您能够更快地响应。17-21

给脓毒症管理带来深远的影响

您的医院等不起

此处介绍的脓毒症集束治疗指南,由CMS于2014年8月4日出版,在此仅供参考。 本信息不构成报销或医疗建议。 Edwards不就本信息或其完整性、准确性或及时性提供担保。 亦不可理解为其是就临床实践提出的建议。 涉及报销的法律、法规和付款方政策复杂且经常变化;服务提供商负责关于临床服务、编码及报销提交的所有决策。 因此,Edwards强烈建议就指南、编码、保险范围及报销事宜咨询CMS、付款方、报销专员和/或法律顾问。

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参考文献
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  3. Liu, Vincent, Gabriel J. Escobar, John D. Greene, Jay Soule, Alan Whippy, Derek C. Angus, and Theodore J. Iwashyna. "Hospital Deaths in Patients With Sepsis From 2 Independent Cohorts." Jama 312.1 (2014): 90. Web.
  4. Statistics, National Center For Health. NCHS Data Brief, Number 62, June 2011 (n.d.): n. pag. www.CDC.gov . Centers for Disease Control, June 2011. Web. 6 Apr. 2016.
  5. World Sepsis Day Sepsis Fact Sheet, 2015.
  6. Marik, Paul E., Xavier Monnet, and Jean-Louis Teboul. 揌emodynamic Parameters to Guide Fluid Therapy.? Ann Intensive Care Annals of Intensive Care 1.1 (2011):1. Web.
  7. Martin, Greg S. 揝epsis, Severe Sepsis and Septic Shock: Changes in Incidence, Pathogens and Outcomes.? Expert review of anti-infective therapy 10.6 (2012): 701–706. PMC. Web. 12 July 2016.
  8. Kumar A, Roberts D, Wood KE, et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med. 2006.
  9. Truijen et al. Noninvasive Continuous Hemodynamic Monitoring. Journal of Clinical Monitoring and Computing. 2012.
  10. 操作手册EV1000_157811A5。
  11. EV1000操作手册(S-0351)。
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  13. Eeftinck Schattenkerk D, et al. Nexfin Noninvasive Continuous Blood Pressure Validated Against Riva-Rocci/Korotkoff. American Journal of Hypertension 2009; 22(4):378-383.
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  15. Dougherty L. Central venous access devices. Nurs Stand. 2000;14(43):45-50. [PubMed]
  16. Moureau N, Poole S, Murdock MA, Gray SM, Semba CP. Central venous catheters in home infusion care: outcomes analysis in 50,470 patients. J Vasc Interv Radiol. 2002;13(10):1009-16. [PubMed]
  17. Reinhart K, et al. Continuous central venous and pulmonary artery oxygen saturation monitoring in the critically ill. Intensive Care Med. 2004;30(8):1572-8.
  18. Rivers EP, et al. Central venous oxygen saturation monitoring in the critically ill patient. Curr Opin Crit Care. 2001;7(3):204-11.
  19. Ingelmo P, et al. Importance of monitoring in high risk surgical patients. Minerva Anestesiol. 2002;68(4):226-30.
  20. Scalea, TM, et al. Central venous oxygen saturation: a useful clinical tool in trauma patients. J Trauma 1990;30(12):1539-43.
  21. Ander, DS, et al. Undetected cardiogenic shock in patients with congestive heart failure presenting to the emergency department. Am J Cardiol 1998;82(7):888-91.
  22. Chen, Caroline, and Doni Bloomfield. "Deadly Infections Drive Billions in Hospital Bills to Medicare." Bloomberg.com . Bloomberg, 15 June 2015. Web. 06 Apr. 2016
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  25. Report to Congress: Medicare and the Health Care Delivery System, June 2015.

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