在V-A ECMO支持期间考虑左心室余负荷的新型回声心脏学参数
Kei Sato1,2, Silver Heinsar1,2,3,4, Jonathan Chan5,6
1Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.
European journal of clinical investigation
|June 7, 2024
概括
一个新的回声心脏学参数,压力-应变产品 (PSP),显示出对在V-A ECMO.上对心脏性休克患者的血液动力学负荷进行非侵入性评估的希望. 这种方法可能为侵入性测量提供可靠的替代方案.
科学领域:
- 心血管生理学心血管生理学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
- 关键护理医学 关键护理医学
背景情况:
- 左心室中风工作指数 (LVSWI) 和心力功率指数 (CPI) 是心脏性休克的关键预后标志物.
- 由于体外循环干扰,在静脉动脉外体膜氧化 (V-A ECMO) 期间精确的非侵入性测量LVSWI和CPI具有挑战性.
研究的目的:
- 为了评估新型的压力-菌株产物 (PSP) 回声心脏学参数在心脏性休克的绵羊模型中.
- 为了确定PSP是否与压力-体积导管衍生LVSWI和CPI相关.
- 在V-A ECMO流量变化期间评估PSP的负载独立性.
主要方法:
- 九只多塞特交叉绵羊接受了诱导的心脏性休克和V-A ECMO支持.
- 同时测量心声回声学参数和压力-体积导管数据在不同的ECMO流量进行.
- 用全球环形或辐射应变乘以平均动脉压来计算PSP.
主要成果:
- 与其他心声学参数相比,PSPcirc与LVSWI (CC=.360) 和CPI (CC=.283) 显示出显著的相关性.
- 对于LVSWI (AUC .82) 和CPI (AUC .80),PSPcirc的可预测性更高.
- 不同的ECMO流速之间没有观察到PSPcirc的显著差异,这表明负载独立.
结论:
- 新的回声心脏学参数PSP显示,在接受V-A ECMO治疗的心脏性休克患者中,对非侵入性预测LVSWI和CPI的潜力.
- 在这种关键设置中,PSP可以提供血液动力学参数的负载独立评估.
- 这一参数可以提高V-A ECMO支持的患者的监测和管理.
关键词:
心脏功率指数是指心脏功率指数.心脏发生的冲击是心脏发生的冲击.左心室中风工作指数工作指数斑点跟踪回声心脏图谱 (speckle-tracking echocardiography) 是一种用于跟踪心脏回声的方法.更多相关视频
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