侵入性机械通风与急性呼吸衰竭患者的右心室应变更糟相关
Shuyuan Wang1,2, Zubair Bashir3, Edward W Chen4
1Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
侵入性机械通风可能会使急性呼吸衰竭患者的右心室功能障碍恶化. 像RVGLS和FWLS这样的RV菌株测量比TAPSE更灵敏地检测这些变化.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 关键护理医学 关键护理医学
背景情况:
- 右心室 (RV) 功能障碍是急性呼吸衰竭 (ARF) 糟糕结果的重要预测因素.
- 对RV功能的心声学评估对于需要侵入性机械通风 (IMV) 的ARF患者的管理至关重要.
研究的目的:
- 为了比较RV菌株参数,特别是RV全球纵向菌株 (RVGLS) 和自由壁纵向菌株 (FWLS) 的疗效,与三环状平面缩外流 (TAPSE) 在检测ARF患者的RV功能障碍时.
- 调查IMV对VR功能潜在的影响.
主要方法:
- 对376名需要IMV的ARF患者的回顾性分析.
- 测量RVGLS,FWLS使用斑点跟踪心声学 (STE),TAPSE使用传统心声学.
- 将患者分为三组:在IMV期间的TTE (TTE-IMV),在IMV之前 (TTE-bIMV) 和IMV后 (TTE-aIMV).
主要成果:
- 在IMV患者中,RVGLS和FWLS显着较低,与IMV前或后患者相比.
- 在TAPSE中,各组之间没有显著的差异.
- 多变量回归分析证实,较低的RVGLS和FWLS与IMV相关 (TTE-bIMV:RVGLSβ = 7.28,FWLSβ = 5.83;TTE-aIMV:RVGLSβ = 9.39,FWLSβ = 7.54).与IMV相关的是较低的RVGLS和FWLS (TTE-bIMV:RVGLSβ = 7.28,FWLSβ = 5.83;TTE-aIMV:RVGLSβ = 9.39,FWLSβ = 7.54).
结论:
- 在ARF患者中,IMV可能会导致或加剧VR功能障碍.
- 在接受IMV的患者中,RVGLS和FWLS在检测亚临床RV功能障碍方面比TAPSE更敏感.
- 需要进行前性研究来证实这些发现,并确定STE衍生的RV菌株的预后价值.
更多相关视频
08:12Invasive Hemodynamic Monitoring of Aortic and Pulmonary Artery Hemodynamics in a Large Animal Model of ARDS
Published on: November 26, 2018
06:22Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome ARDS
Published on: April 7, 2021
相关概念视频
Mechanical Ventilation II: Invasive Ventilation
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
Mechanical Ventilation I: Indication and Settings
Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation...
Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
Ventilatory Modes
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
