血管收缩与烯增加心脏输出在预负载依赖的患者预负载
Jakob Højlund1, Mirjana Cihoric2, Nicolai Bang Foss2
1Department of Anaesthesiology, Hvidovre University Hospital, Capital Region, Denmark. jakob.hoejlund@regionh.dk.
Journal of clinical monitoring and computing
|June 21, 2024
概括
在全身麻醉期间注入烯有效地恢复了对预负荷依赖的患者的心脏预负荷. 这改善了中风体积和心脏输出,证明了其超出血压管理的效用.
科学领域:
- 麻醉学 麻醉学
- 心血管生理学心血管生理学
- 药理学 药理学是指药理学的学科.
背景情况:
- 总麻醉减少了同情的外流,损害了血管运动控制和心脏预负载.
- 烯 (PE) 是一种纯α1激动剂,用于手术内低血压,但其通过静脉招募对心脏输出的影响仍在争论中.
- 缺乏使用指示器稀释技术对PE对预负载依赖循环的影响的人体研究.
研究的目的:
- 在全身麻醉下研究烯输注对恢复预负荷和增加预负荷依赖患者中中风体积和心脏输出的影响.
- 评估烯在通过静脉招募增加心脏中风体积和输出方面的有争议的潜力.
主要方法:
- 20名为胃肠道手术进行全身麻醉的患者使用动脉导管和LiDCO统一监视器进行监测.
- 患者被放置在头向上倾斜,以诱导预加载响应 (SVV>12%).
- 用于恢复预加载 (SVV <12%) 的费尼莱弗林输注,心脏输出通过基线指标稀释测量,在头向上倾斜期间和PE输注后.
主要成果:
- 抬头倾斜将中风体积变化 (SVV) 增加到19%,并降低心脏指数 (CI) 和中风体积指数 (SVI).
- 乙烯注入将SVV降低到6%,显著增加CI和SVI.
- 利弗林输注期间观察到的所有血液动力学变化都具有统计学意义 (p < 0.001).
结论:
- 在全身麻醉下对预负荷依赖的患者注入烯增加了静脉回流.
- 这有效地取消了预加载依赖,如SVV规范化所示.
- 乙烯的使用增加了心脏中风的体积和心脏输出,通过指标稀释技术测量.
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