在急性循环衰竭中,体积输液对左心房应变的影响
Marta Cicetti1,2, François Bagate3,4, Cristina Lapenta1
1Service de Médecine Intensive Réanimation, AP-HP, Centre Hôpitaux Universitaires Henri Mondor, DHU A-TVB, 1 rue Gustave Eiffel, Créteil Cedex, F-94010, France.
Annals of intensive care
|April 9, 2024
概括
左心房应变 (LAS) 在患有循环衰竭的重症患者中降低. 虽然LAS随着液体的使用而改善,但它无法预测这些患者的液体反应.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 左心房应变 (LAS) 衡量心房变形和心脏表现.
- 血动力学不稳定,重症患者中LAS的作用仍然未被探索.
- 这项研究调查了急性循环衰竭中的LAS及其对液体膨胀的反应.
研究的目的:
- 描述急性循环衰竭患者的LAS及其组成部分.
- 分析在体积膨胀期间LAS的变化.
- 评估 LAS 组件和流体响应之间的关系.
主要方法:
- 法国ICU的前性观察研究.
- 包括急性循环衰竭患者接受体积扩张 (500毫升晶体).
- 液体输注前后的跨胸腔心声图;在线执行LAS分析. 流体反应能力定义为VTI增加≥10%.
主要成果:
- 分析了38名患者; 45%是流体反应者.
- 在基线,LAS组件 (水库,管道,收缩) 显著减少.
- LAS成分显著增加了体积后扩张,但基线LAS没有预测流体响应.
结论:
- 在急性循环衰竭中,左心房应变显著受损.
- 虽然LAS成分随着液体的使用而增加,但它们不是液体响应的可靠预测指标.
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