患有心脏坦普的患者体积膨胀的血液动力学效应
Jaume Sagristà-Sauleda1, Juan Angel, Antonia Sambola
1Servei de Cardiologia, Hospital Universitari Vall d'Hebron, P. Vall d'Hebron 119-129, 08035 Barcelona, Spain. jsagrist@vhebron.net
Circulation
|March 12, 2008
概括
体积膨胀可以改善大约一半的心脏坦波尼患者的心脏输出. 低缩血压是这种对液体过载的积极反应的关键预测因素.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
背景情况:
- 心脏吸管管理缺乏关于体积膨胀的强有力的证据.
- 流体过载是一种被提议的,但研究不充分的,治疗心脏栓塞的方法.
研究的目的:
- 为了评估心脏坦波尼德患者体积扩张的疗效.
- 为了确定心脏吸管中流体过载对有利的血液动力学反应的预测因素.
主要方法:
- 49名心脏吸管患者经历了500毫升正常盐水的液体过载.
- 血液动力学参数包括心脏指数和压力在液体注射之前和之后被测量.
- 在流体过载后,进行了心脏周周测试.
主要成果:
- 体积膨胀显著增加了平均动脉压和心脏指数.
- 内心心室内,右心室内和左心室内末端透静压力也显著增加.
- 几乎一半的患者 (47%) 显示心脏指数>10%增加;基线低缩血压 (<100毫米升) 预测了这种反应.
结论:
- 体积膨胀在大约50%的心脏吸管患者中提供了显著的血液动力学益处.
- 基线压缩血压低于100毫米平线是一个简单的,有效的预测器,对液体过载的积极反应.
相关概念视频
Imbalances in Cardiac Output
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
Cardiac Output II: Effect of Stroke Volume on Cardiac Output
Cardiac output (CO), the amount of blood the heart pumps per minute, is a parameter in cardiovascular physiology determined by stroke volume and heart rate. Stroke volume, the amount of blood pushed from one of the ventricles per heartbeat, is influenced by preload, afterload, and contractility.
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...
Preload
Preload refers to the initial elongation of the cardiac myocytes before contraction and is related to the volume of blood filling the heart at the end of diastole, or end-diastolic volume. The...
Cardiovascular System Abnormal Findings I: Inspection and Palpation
In a cardiovascular examination, inspection and palpation are crucial for identifying abnormalities.
Abnormal findings observed during an inspection
Abnormal findings observed during an inspection
Mitral Stenosis I: Introduction
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
Heart Failure II: Pathophysiology
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
Heart Failure III: Clinical Manifestations
Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...


