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My patient has no blood pressure: is their heart working?

机译：我的病人没有血压：他们的心脏在工作吗？

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How can point-of-care (PoC) ultrasound be used to help the clinician identify cardiogenic and certain non-cardiogenic causesnof undifferentiated, non-traumatic hypotension? Hypotension is a common emergency presentation in the emergencyndepartment and medical admissions unit. Due to the physiological complexities of this state, the aetiology is often unclear tonclinicians at initial presentation. This has clear implications for treatment and outcomes of the patient. Clinical indicators suchnas vital signs and physical examination are often unreliable in distinguishing causes of hypotension, identifying the correctnaetiology in only 25–50% of cases. PoC ultrasound (PoCUS) of the heart can help differentiate between cardiogenic causesnsuch as left ventricular dysfunction, and obstructive causes such as cardiac tamponade, and can point towards other causesnsuch as sepsis and hypovolaemia. Limited cardiac echocardiography or ‘echo in life support’ can be performed as a part ofngoal-directed protocols for undifferentiated, non-traumatic hypotension. Use of such protocols early can significantly improventhe diagnostic accuracy to 80%, thereby reducing the time to diagnosis and the time to initiating appropriate therapies. In thisnarticle, we review our approach to PoCUS of the heart in the setting of hypotension.
机译：即时护理（PoC）超声如何用于帮助临床医生识别未分化，非创伤性低血压的心源性和某些非心源性原因？低血压是急诊科和医疗机构的常见急诊表现。由于这种状态的生理复杂性，病因在初诊时通常是不清楚的tonclinicians。这对于患者的治疗和结果具有明显的含义。临床指标，如生命体征和体格检查通常不能可靠地区分低血压的原因，仅在25％至50％的病例中就可以确定正确的病因。心脏的PoC超声（PoCUS）可以帮助区分心源性原因（例如左心室功能障碍）和阻塞性原因（例如心脏压塞），并且可以指出其他原因，例如败血症和低血容量。对于未分化，非创伤性低血压，可将有限的心脏超声心动图或“维持生命的回声”作为神经系统指导方案的一部分进行。尽早使用此类方案可以将诊断准确性显着提高到80％，从而减少诊断时间和启动适当治疗的时间。在本文中，我们回顾了在低血压情况下对心脏进行PoCUS的方法。

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