虚弱对左心室辅助装置的影响 临床结果
Steven Imburgio1, Ndausung Udongwo2, Anton Mararenko2
1Department of Medicine, Jersey Shore University Medical Center, Neptune City, New Jersey.
The American journal of cardiology
|September 21, 2023
概括
左心室辅助装置 (LVAD) 植入并没有增加虚弱心力衰竭患者的住院患者死亡率或30天再入院率. 这些发现支持在高风险人群中继续使用LVAD.
科学领域:
- 心脏病学 心脏病学
- 老年病的医生 老年病的医生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 衰弱在老年人中很常见,并且与心力衰竭患者的不良结果有关.
- 左心室辅助器件 (LVAD) 对于末期心力衰竭管理至关重要.
- 脆弱对LVAD结果的影响需要进一步调查.
研究的目的:
- 评估LVAD植入后脆弱性对临床结果的影响.
- 为了比较虚弱和非虚弱患者之间的住院死亡率,30天再入院,住院时间和出院倾向.
主要方法:
- 全国再接收数据库 (2014-2020年) 的回顾性分析.
- 鉴定接受LVAD植入的心力衰竭患者.
- 用医院脆弱性风险评分分类分为脆弱和非脆弱的群体.
- 考克斯和物流回归分析来评估结果.
主要成果:
- 11,465名患者符合纳入标准;81.6%的LVAD接受者是脆弱的.
- 在脆弱患者中,LVAD植入与住院患者死亡率增加无关 (HR 1.15,p=0.427).
- 虚弱的患者没有更高的30天再入院的可能性 (HR 1.15,p=0.239).
结论:
- 在脆弱心力衰竭患者中,LVAD植入对于住院患者的死亡率和再入院率是安全的.
- 这些发现支持在脆弱,高风险的心力衰竭人群中继续使用LVADs.
- 虚弱不应该成为LVAD治疗的绝对禁忌.
更多相关视频
07:39Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
Published on: August 16, 2021
3.6K
06:10Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
3.3K
相关概念视频
Heart Failure III: Clinical Manifestations
22
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...
22
Heart Failure II: Pathophysiology
14
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...
14
Heart Failure V: Medical Management
12
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
12
Heart Failure I: Introduction
14
Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
14
Heart Failure VI: Adjunct Therapies
16
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
16
Heart Failure VII: Nursing Interventions
89
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
89
