Application of venous return curve in hemodynamic intervention of shock patients / 中华危重病急救医学

ABSTRACT

In the cardiac output (CO) and venous return (VR) balance theory proposed by Guyton in the 1950s, the right atrial pressure (Pra) was used as the dependent variable, and the VR and right cardiac function curves were recorded simultaneously. The intersection of the two curves is the current circulating blood flow under the Pra at this moment. In patients with hemodynamically unstable shock, the primary treatment goal is to restore circulating blood volume and tissue perfusion with primary methods including fluid resuscitation and the use of vasoactive drugs. This review described the dynamic evolution of VR curve in hemodynamic intervention of shock patients and the changes in physiological indicators such as mean systemic filling pressure (Pmsf), venous resistance (Rv), and stressed volume (Vs), in order to more accurately interpret changes in hemodynamic parameters and guide the clinical treatment of shock from a goal-oriented perspective.