Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: The microcirculation of the critically ill pediatric patient. | Top et al. Critical Care 2011 15 213 http content 15 2 213 CRITICAL CARE REVIEW L_ The microcirculation of the critically ill pediatric patient Anke PC Top1 2 Robert C Tasker1 Can Ince3 This article is one of eleven reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2011 Springer Verlag and co-published as a series in Critical Care. Other articles in the series can be found online at http series annual. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http series 8901 Introduction Hemodynamic monitoring is the cornerstone of critical care especially when the patient is hemodynamically unstable. It needs to be used with the perspective of tailoring treatment to physiology and the underlying disease process 1 . Monitoring should be easy to apply and negative side effects should be limited. The results should be reliable and reproducible not least because we also need to monitor response to therapy when cardiovascular insufficiency has been identified. One of the primary goals of hemodynamic monitoring is to alert the physician to impending cardiovascular crisis before organ or tissue injury ensues. In general the adequacy of circulatory stability is judged by clinical assessment of parameters that we can measure . blood pressure urine output heart rate and serum lactate concentration. However these are indirect clinical markers of systemic blood flow and as such they are unreliable estimates of overall hemodynamic status during critical illness irrespective of the experience of the assessing clinician 2 3 . The logic is obvious when one considers that since blood pressure is a regulated variable a normal blood pressure does not necessarily reflect hemodynamic stability or perturbation 4 . Early recognition of hemodynamic instability in combination with an understanding of the often complex underlying pathophysiology is therefore .
