静脈内容量蘇生後のセプティックショックにおけるニトログリセリン
Peter E Spronk1, Can Ince, Martin J Gardien
1Department of Intensive Care Medicine, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands.
Lancet (London, England)
|November 9, 2002
まとめ
ニトログリセリンは,セプティックショック患者の微循環血流を改善しました. これは,微循環の強化が, сепティックショックにおける新たな蘇生標的となる可能性があることを示唆している.
科学分野:
- クリティカルケア・メディシン
- 生理学 生理学とは
- メディカルイマージング (医学イメージング)
背景:
- セプティックショックには,酸素の消費が増加し,マイクロ循環器の機能不全により,配送/抽出が損なわれます.
- 微循環器の停止とシャントは,セプティックショックにおける酸素供給の低下に寄与する.
- オートゴナル・ポラライゼーションスペクトル (OPS) 画像は,マイクロ循環の直接視覚化を提供します.
研究 の 目的:
- セプティックショック患者におけるニトログリセリンの微循環器の流れへの影響を評価する.
- 再蘇生エンドポイントとして,マイクロ循環器のリクルートメントの可能性を評価する.
主な方法:
- 微循環を視覚化するために,直角極化スペクトル画像 (OPS) を利用しました.
- セプティックショックと特定の血液動力学パラメータ (MAP>60mmHg,CVP>12mmHg) を有する患者さんをモニターした.
- 静脈内注射のニトログリセリン (0.5mg) を投与し,マイクロ血管の流れの変化が観察されました.
主要な成果:
- ニトログリセリンの注入は,OPS画像を通して観察されたマイクロ血管の流れの有意な増加をもたらしました.
- ニトログリセリン投与後,微循環器の perfusion が改善されたことが実証されています.
- 微循環の増強が観察されました.
結論:
- ニトログリセリンは,セプティックショックにおける微循環血流を効果的に改善します.
- 微循環器のリクルートメントは, сепティックショック管理における新しい,貴重な蘇生エンドポイントとして役立つかもしれません.
- OPSイメージングは,重症病における介入に対するマイクロ循環器の反応を評価するための有効なツールです.
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