在重症患者中,败血性心肌病现型可能取决于抗菌素耐药性
Vasiliki Tsolaki1, Kyriaki Parisi1, George E Zakynthinos2
1Intensive Care Unit, University Hospital of Larissa, University of Thessaly Faculty of Medicine, Larissa, Greece.
Journal of intensive medicine
|July 22, 2024
概括
多抗药性 (MDR) 感染中的败血性心肌病 (SCM) 主要影响右心室功能,而非MDR SCM主要影响左心室功能. 这突出了基于病原体耐药性的独特心脏影响.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 败血症是一种导致器官功能障碍的严重疾病,败血性心肌病 (SCM) 是潜在的并发症.
- 由多药耐药 (MDR) 病原体引起的感染与患者的治疗结果较差有关.
- 在抗微生物药物耐药性的背景下了解SCM对于有效的患者管理至关重要.
研究的目的:
- 研究和比较感染多药耐药 (MDR) 病原体与非MDR病原体的患者的败血性心肌病 (SCM).
- 评估MDR-SCM组与非MDR-SCM组之间的心脏功能,特别是左心室和右心室功能的差异.
主要方法:
- 一项回顾性研究涉及62名在2022年1月至2023年9月期间入住重症监护病房的败血症/败血性休克患者.
- 根据病原体耐药性,患者被分为MDR-SCM和非MDR-SCM组.
- 在感染发作后的前两天内收集的心声图数据被分析,以比较心脏功能.
主要成果:
- 在41.9%的患者中观察到左心室 (LV) 缩功能障碍,在56.4%的患者中观察到右心室断片面积变化 (RVFAC ≤35%) 的损伤.
- 与MDR-SCM组相比,非MDR-SCM组表现出更严重的LV缩功能障碍 (排泄分数,流出通道VTI和应变).
- 与非MDR-SCM组相比,MDR-SCM组显示出更显著的右心室 (RV) 扩张和更差的RV缩功能 (RVFAC,S波速度和RV菌株).
结论:
- 与多药耐药性感染相关的败血性心肌病主要表现为右心室缩功能障碍.
- 非MDR感染中的败血性心肌病主要以左心室缩功能障碍为特征.
- 这些发现表明,基于致病原体的抗微生物耐药性概况,心脏参与的不同模式.
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