重症监护病房的腹腔科医生:评估的挑战和未来的方向
Filipe A Gonzalez1,2, Cristina Santonocito3, Marc O Maybauer4
1Intensive Care Department of Hospital Garcia de Orta, Almada, Portugal.
Echocardiography (Mount Kisco, N.Y.)
|February 21, 2024
概括
左心室扩张功能障碍 (DD) 越来越多地与重症监护室 (ICU) 患者的不良结果有关,特别是患有败血症的患者. 新的方法可以改善诊断和治疗心脏功能障碍在严重疾病.
科学领域:
- 关键护理医学 关键护理医学
- 心脏病学 心脏病学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 心肌功能障碍在重症监护室 (ICU) 的入院者中普遍存在.
- 败血症是ICU入院和死亡的主要原因,经常导致心脏功能障碍.
- 左心室 (LV) 缩功能障碍与危急病患者的死亡率的联系尚不清楚,但LV 缩功能障碍 (DD) 与不良结果有关.
研究的目的:
- 讨论在重症患者中诊断和评分DD的挑战.
- 突出左心房压估计对ICU患者管理的重要性.
- 探索整合LV和左心房应变数据以提高诊断准确性和预后影响.
主要方法:
- 综述当前关于危急病患者的舒张功能障碍的文献.
- 对DD评估的回声心脏学参数的分析.
- 讨论现有DD指南在ICU环境中的局限性.
主要成果:
- 越来越多的人认为, LV 扩张功能障碍 (DD) 是危急病患者 (包括败血症) 结果不佳的预测因素.
- 当前的DD分类和指导方针在ICU环境中提出了挑战.
- 左心房压的估计对于管理ICU患者至关重要.
结论:
- 在重症患者中确切诊断和分类DD仍然是复杂的.
- 整合LV和左心房应变数据可能会提高心脏功能障碍的诊断准确性和治疗策略.
- 对心脏功能障碍谱的更好理解对于危急疾病的预后和管理至关重要.
相关概念视频
01:25Assessment of the Cardiovascular System IV: Auscultation
330
Cardiac auscultation is a clinical skill used to assess heart function and detect abnormalities. It involves listening to heart sounds at specific anatomical locations through a stethoscope.
Normal Heart Sounds
S1 (First Heart Sound)-
S1 is made by the closure of the mitral and tricuspid valves (atrioventricular valves), marking the beginning of systole.
S2 (Second Heart Sound)-
S2 is made by the closure of the aortic and pulmonic valves (semilunar valves), marking the end of the systole.
Normal Heart Sounds
S1 (First Heart Sound)-
S1 is made by the closure of the mitral and tricuspid valves (atrioventricular valves), marking the beginning of systole.
S2 (Second Heart Sound)-
S2 is made by the closure of the aortic and pulmonic valves (semilunar valves), marking the end of the systole.
330
01:29Assessment of Ventilation II: Respiratory Depth and Rhythm
1.5K
Respiratory Depth
Respiratory depth measures the volume of air inhaled or exhaled during a breath. It can vary from shallow to deep and typically remains consistent when a person is at rest or asleep. Occasionally, individuals will automatically inhale deeply, known as sighing, which inflates the lungs with more air than normal breathing.
To assess respiratory depth, observe the degree of chest excursion or movement:
Respiratory depth measures the volume of air inhaled or exhaled during a breath. It can vary from shallow to deep and typically remains consistent when a person is at rest or asleep. Occasionally, individuals will automatically inhale deeply, known as sighing, which inflates the lungs with more air than normal breathing.
To assess respiratory depth, observe the degree of chest excursion or movement:
1.5K
01:17Imaging Studies for Cardiovascular System I:Echocardiography
331
Cardiac imaging studies encompass a wide range of noninvasive and minimally invasive techniques designed to visualize the heart's structure and function in detail. One such technique is echocardiography, which uses high-frequency ultrasound waves to produce detailed images of the heart, known as echocardiograms.
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
331
01:27Assessment of the Cardiovascular System III: Palpation
340
Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
340
01:30Pneumonia III: Complications and Assessment
215
Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
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01:30Pulse rhythm
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Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
798