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在模拟性低血压期间进行全面的心声回声分析:观察性研究

Aarne Feldheiser¹, Peter Juhl-Olsen, Michael Nordine

¹From the Department of Anaesthesiology and Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany (AF, MS, LW), Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Evang. Kliniken Essen-Mitte, Huyssens-Stiftung/Knappschaft, Essen, Germany (AF), Department of Cardiothoracic- and Vascular Surgery, Anaesthesia Section, Aarhus University Hospital, Aarhus, Denmark (PJ-O), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität and Humboldt Universität zu Berlin, Department of Anesthesiology and Intensive Care Medicine, Charité Campus Benjamin Franklin, Berlin, Germany (MN, ST, CB), Sana Berlin-Klinkum Lichtenberg, Fanninger Straße 32, 10365 Berlin und Charité Universitätsmedizin, Campus Mitte, Klinik für Kardiologie und Angiologie. 10098 Berlin (FK).

European journal of anaesthesiology

|June 2, 2023

概括

轻度低血压可能会损害心脏功能,即使血压正常. 心声图显示在模拟低血压期间,中风体积指数和心室性能下降.

科学领域:

心脏病学心脏病学
关键护理医学关键护理医学
身体生理学身体生理学

背景情况:

术前和重症患者可能会经历低血压休克,保持平均动脉压 (MAP) 和心率 (HR),但降低中风体积指数 (SVI).
了解轻度至中度低血压期间的心声学变化对于及时干预至关重要.

研究的目的:

为了评估响应模拟轻度至中度中央低血压的回声心脏学参数.
为了评估心肌功能和心脏体积在分级低血压期间的变化.

主要方法:

未来临床前研究涉及30名健康的男性志愿者.
模拟的低血压使用下体负压 (LBNP) 在-15,-30,和-45 mmHg.
在每个阶段进行的跨胸腔心声学 (TTE),以测量心缩和心缩功能,以及心脏体积.

主要成果:

脑卒中体积指数 (SVI) 随着低血压的增加而逐渐下降.
左心室 (LV) 喷射分数在-30和-45mmHg下降.
LV全球纵向应变 (LV GLS),三环状平面缩外流 (TAPSE) 和右心室 (RV) S'下降,表明心室功能受损. 左心房末缩体积 (LA ESV) 也下降了.

结论:

通过LBNP模拟的中央低血压并没有持续改变MAP或HR.
观察到SVI的减少,与回声心脏学证据相关的右心室和左心室功能恶化的证据.
降低LA ESV的特征是模拟低血压期间填充状态的降低.

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