[Experts consensus on the management of the right heart function in critically ill patients].

作者：Xudong Wang, D W Liu, Hudie Zhang, Yun Long, Xuechun Guan, Haibo Qiu, Kuaikuai Yu, Jinyuan Yan, Haiying Zhao, Yi-Da Tang, Xin Ding, X C, Wenxu Du, Yoonjin Kang, Benjamin C. Tang, Yuhang Ai, Hongchuan He, D C Chen, H Chen, W. Chai, Xianshi Zhou, Na Cui, H Wang, Xue Rui, Zhanqi Hu, J G Li, Yun Xu, Yi Yang, B Ouyan, Hua Lin, Y M Li, Xin Wan, Rongyuan Yang, Yujie Qin, Y G Chao, Zhenyu Xie, Runfeng Sun, Zhiqiang He, Dixuan Wang, Qin Huang, Dan Jiang, Xueyuan Cao, Ruijiao Yu, X Wang, Xiaolin Chen, Jieling Wu, L N Zhang, Ming Yin, L X Liu, S W Li, Z J Chen, Zhe Luo · 发表于：PubMed · 年份：2017 · DOI：10.3760/cma.j.issn.0578-1426.2017.12.017 · 被引用次数：12 · 研究领域：Pulmonary Hypertension Research and Treatments

To establish the experts consensus on the right heart function management in critically ill patients. The panel of consensus was composed of 30 experts in critical care medicine who are all members of Critical Hemodynamic Therapy Collaboration Group (CHTC Group). Each statement was assessed based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) principle. Then the Delphi method was adopted by 52 experts to reassess all the statements. (1) Right heart function is prone to be affected in critically illness, which will result in a auto-exaggerated vicious cycle. (2) Right heart function management is a key step of the hemodynamic therapy in critically ill patients. (3) Fluid resuscitation means the process of fluid therapy through rapid adjustment of intravascular volume aiming to improve tissue perfusion. Reversed fluid resuscitation means reducing volume. (4) The right ventricle afterload should be taken into consideration when using stroke volume variation (SVV) or pulse pressure variation (PPV) to assess fluid responsiveness.(5)Volume overload alone could lead to septal displacement and damage the diastolic function of the left ventricle. (6) The Starling curve of the right ventricle is not the same as the one applied to the left ventricle,the judgement of the different states for the right ventricle is the key of volume management. (7) The alteration of right heart function has its own characteristics, volume assessment and adjustment is an ...