中心环状平面缩外观评估左心室缩功能障碍在患有败血性休克的患者
Clément Brault1, Yoann Zerbib1, Pablo Mercado1,2
1Intensive Care Department, Amiens-Picardie University Hospital, Amiens, France.
BJA open
|August 28, 2023
概括
使用隔膜位子环状平面缩外流 (MAPSE) 的床边回声心电图可以预测左心室缩功能障碍在败血性休克患者. 这种简单的测量有助于早期检测,当菌株成像无法使用时.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 心声回声图 (Echocardiography) 是一种心声回声图.
背景情况:
- 败血性休克经常导致左心室 (LV) 缩功能障碍.
- 精确评估LV功能对于管理败血症休克至关重要.
- 评估 LV 功能的传统方法在危急病患者中可能是有限的.
研究的目的:
- 开发和验证一个回声心脏算法来预测左心室喷射率 (LVEF) 和纵向应变 (LVLS) 在败血性休克.
- 为了确定简单的床边测量来评估LV缩功能障碍.
主要方法:
- 研究了71名败血症休克患者.
- 测量包括隔膜和侧面美特拉环状平面缩外流 (MAPSE),美特拉S波速度和LV纵向壁的分数缩短.
- 使用条件推论树模型来开发LV系统功能障碍的预测算法 (定义为LVEF <50%或LVLS > -17%).
主要成果:
- 截面MAPSE (切线:1.2厘米) 是LV缩功能障碍的最强预测因素.
- 在94%的患者中,隔膜MAPSE≥1.2厘米正确预测了正常的LVEF.
- 在87%的患者中,隔膜MAPSE<1.2厘米预测了LV系统功能障碍与LVLS受损,尽管60%的患者保持了LVEF.
结论:
- Septal MAPSE是一种随时可用的床边测量.
- 这种简单的心声回声学参数可以帮助临床医生在感染性休克中早期检测LV静脉缩功能障碍.
- 当先进的心肌应变测量不可行时,它特别有用.
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