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保护心脏手术:战略性的机械循环支持,以改善心脏切除术后的死亡率
Leonardo Salazar1,2, Roberto Lorusso1,3
1Cardio-Thoracic Surgery Department, Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands.
Current opinion in critical care
|July 3, 2024
概括
在复杂的心脏手术中,主动使用机械循环支持 (MCS) 可以预防外科手术期间的低心力输出综合征 (P-LCOS). 早期识别高风险患者和计划MCS改善了结果.
科学领域:
- 心血管外科心血管外科
- 关键护理医学 关键护理医学
背景情况:
- 心脏手术患者群体越来越复杂.
- 术后低心力输出综合征 (P-LCOS) 是死亡率的主要预测因素.
- 机械循环支持 (MCS) 对于管理P-LCOS至关重要.
研究的目的:
- 为了回顾心脏外科手术不断发展的景观.
- 突出MCS在P-LCOS管理中的作用.
- 讨论保护心脏手术的概念.
主要方法:
- 关于心脏手术复杂性和MCS的当前文献的综述.
- 对P-LCOS的风险因素的分析.
- 讨论主动与反应性的MCS策略.
主要成果:
- 手术前的风险因素 (心脏性休克,乳糖水平升高) 确定高风险患者.
- 在P-LCOS发作之前主动实施MCS可以改善结果.
- 保护心脏手术涉及早期风险识别和计划的MCS.
结论:
- 对高风险心脏手术患者来说,多学科,主动的方法是必不可少的.
- 早期,计划的MCS可以预防P-LCOS并改善生存率.
- 量身定制的MCS策略和道德考虑对于受保护的心脏手术至关重要.
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