在患有败血症的老年患者中确定心肌损伤的危险因素
Yong-Yan Han1, Jun-Li Yang1, Hui-Min Meng1
1Department of Emergency, Hengshui People's Hospital, Hengshui, Hebei, China.
概括
老年败血症患者有败血性休克,排泄率降低 (EF),血尿素与白蛋白比率 (BAR) 和乳酸水平升高,面临心肌损伤的更高风险. BAR可以作为这种并发症的早期标志物.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 老年病的医生 老年病的医生
背景情况:
- 心肌损伤是老年败血症患者的常见和严重并发症.
- 识别风险因素对于改善这一群体的结果至关重要.
研究的目的:
- 确定进入紧急重症监护室 (EICU) 的老年败血症患者心肌损伤的临床特征和独立风险因素.
主要方法:
- 在EICU的160名老年败血症患者的回顾性分析.
- 人口数据,炎症标志物,心声学参数和血尿素与白蛋白比率 (BAR) 的比较.
- 使用后勤回归和ROC曲线分析来确定风险因素并评估BAR的预测价值.
主要成果:
- 心肌损伤发生在63.1%的患者中,与较低的射出分数 (EF) 和升高的前素,乳酸和BAR相关.
- 心肌损伤的独立风险因素包括败血性休克,升高的BAR和升高的乳酸盐水平.
- 增加EF具有保护作用,而减少EF表明风险更高. 巴尔显示中等的预测值 (AUC=0.653).
结论:
- 败血性休克,降低EF,升高BAR和乳酸水平是老年败血症患者心肌损伤的重要独立风险因素.
- BAR可以作为心肌损伤的早期指标,协助EICU环境中的风险分层和风险管理.
相关概念视频
Imbalances in Cardiac Output
1.2K
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.2K
Blood Studies for Cardiovascular System I: Cardiac Biomarkers
73
Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
73
Factors Affecting the Risk of Infection
10.6K
The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
10.6K
Pathophysiology of Heart Failure
1.4K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.4K
Pathophysiology of Cardiac Performance
495
Typical heart performance is influenced by heart rate, rhythm, myocardial contraction, and metabolism or blood flow. The cardiac muscle exhibits distinct electrophysiological features, including pacemaker activity and calcium channel control, which play a vital role in the heart's response to various drugs. The autonomic nervous system, comprising the sympathetic and parasympathetic branches, regulates heart rate. Sympathetic activation increases heart rate, while parasympathetic activation...
495
Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
39
Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
39


