在机械通风COVID-19 ARDS患者中对右心室功能和肺血液动力学进行全面的时间分析
Vasiliki Tsolaki1, George E Zakynthinos2, Nikitas Karavidas1
1Critical Care Department, Faculty of Medicine, University Hospital of Larissa, University of Thessaly, Mezourlo, 41110, Larissa, Greece.
Annals of intensive care
|February 12, 2024
概括
右心室 (RV) 功能障碍在严重的COVID-19急性呼吸困扰综合征 (ARDS) 中很常见. 在重症监护室 (ICU) 停留期间,RV功能和后负荷的改善与更好的呼吸功能和生存相关.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 密集护理医学 密集护理医学
背景情况:
- 心脏损伤,特别是影响右心室 (RV),是COVID-19患者经常出现的并发症.
- 进入重症监护室 (ICU) 的严重COVID-19急性呼吸困扰综合征 (ARDS) 在管理心脏功能方面存在重大挑战.
研究的目的:
- 在严重的COVID-19ARDS患者中系统评估心脏功能和纵向变化.
- 评估心脏功能对机械通风患者生存的影响.
主要方法:
- 在机械通风的COVID-19 ARDS患者中使用2D/3D心声学进行前性综合性心声学分析.
- 定义左心室 (LV) 和右心室 (RV) 功能障碍,使用射出分数 (EF),纵向应变 (LS),分数面积变化 (FAC) 和三环缩平面 (TAPSE).
- 评估RV后负荷和右心室动脉合 (VACR) 使用肺动脉抽缩压 (PASP),右心室外流通道中的PASP/速度时间积分 (VTI_RVOT) 和肺加速时间 (PAcT).
主要成果:
- 在176名患者中,RV功能障碍是普遍存在的 (69%),通常具有RV扩张.
- 在大多数患者中观察到RV后负载增加.
- 幸存者在ICU住院的第10天显示呼吸系统生理学,RV后负荷和RV缩功能显著改善.
- 在RV功能和后负载的改善与呼吸系统合规性相关 (C_RS).
- 在87.5%的患者中,左心室 (LV) 损伤被发现,LV-LS是敏感的指标.
结论:
- 到第10天,右心室 (RV) 功能,RV后负荷和RV-肺动脉 (PA) 合的改善与改善的呼吸功能有关.
- 这些心脏改善与严重的COVID-19ARDS患者的存活率提高有关.
关键词:
在 ARDS 中,ARDS 是指 ARDS 的类型.在 COVID-19 疫情中,心脏功能是如何运转的血液动力学 血液动力学对于PEEP来说,这是一个很好的方法.肺血管阻力 肺血管阻力在RV功能障碍,RV功能障碍.压力应变是一种压力.更多相关视频
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