新生儿有败血性休克时心声图的特征
Kumari Gunjan1, Manoj Modi1, Anup Thakur1
1Department of Neonatology, Institute of Child Health, Sir Ganga Ram Hospital, New Delhi, India.
European journal of pediatrics
|January 26, 2024
概括
心声图可能无法区分新生儿的败血症休克和稳定的新生儿. 新生儿患有格拉姆阴性败血症难以改善心脏功能,即使使用了内类药物.
科学领域:
- 新生儿心脏病学 新生儿心脏病学
- 儿科重症监护中心儿童重症监护中心
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 在新生儿败血性休克的血液动力学评估是有限的.
- 功能性回声心脏学提供了心脏功能的床边评估.
- 有限的数据存在于震惊的新生儿的回声心脏学参数.
研究的目的:
- 将新生儿的心声学特征与感染性休克与健康对照进行比较.
- 在诊断时评估心声回声学参数的变化,在液体玻尿酸后和在无otropic 支持后评估.
- 评估心声回声学在诊断休克和指导治疗中的实用性.
主要方法:
- 在III级NICU进行前性观察研究.
- 招募了36名患有败血性休克的新生儿和30名年龄相匹配的对照.
- 与心声回声学参数进行比较,包括心室输出和指数.
主要成果:
- 在呈现时,冲击和对照组之间没有心室输出或心肌性能指数的显著差异.
- 下静脉腔张张度指数在患有冲击的新生儿中较高 (17%对10%,p<0.01).
- 在新生儿患有败血性休克后,心脏功能在异型疗法后没有显著改善.
结论:
- 心声学参数可能无法从稳定的新生儿中可靠地区分败血性休克.
- 新生儿的格拉姆阴性败血症诱导的冲击表现出心脏功能受损.
- 来自格拉姆阴性感染的细胞因子可能会影响心肌和血管上腺受体,限制对治疗的反应.
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