肝移植患者的术后心血管评估和管理
Ali O Ibrahim1, Mohamed Salah Mohamed, Valentyna Ivanova
1Department of Cardiovascular Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA.
Current opinion in anaesthesiology
|June 16, 2025
概括
心血管疾病 (CVD) 对患有末期肝病 (ESLD) 的患者构成重大风险,特别是在肝移植 (LT) 期间. 标准化的心血管评估和管理对于改善患者的治疗结果和减少并发症至关重要.
科学领域:
- 心脏病学 心脏病学
- 肝病学 肝病学是一种肝病学.
- 移植医学 移植医学
背景情况:
- 心血管疾病 (CVD) 是最终阶段肝病 (ESLD) 患者的主要死亡原因,特别是在肝移植 (LT) 周围.
- 目前对ESLD患者的心血管风险评估和管理策略不一致.
- 本综述综合了ESLD患者经历LT的心血管问题的最新发现.
研究的目的:
- 审查最近在经过LT的ESLD患者心血管疾病的研究结果.
- 突出需要在这个人群中进行标准化的心血管评估和优化.
- 强调多学科方法对心血管管理的重要性.
主要方法:
- 关于ESLD患者心血管疾病最近发现的文献综述.
- 综合了关于肝硬化,门高血压和心血管功能障碍之间的相互作用的数据.
- 分析移植前查和风险分层方面的进展.
主要成果:
- 肝硬化有助于心血管功能障碍,包括肝硬化心肌病,冠状动脉疾病,心律失常和心力衰竭.
- 移植前查正在转向使用非侵入性成像和选择性冠状动脉血管学的风险分层方法.
- 心血管并发症在LT期间和之后很常见,免疫抑制可以增加长期心血管疾病风险.
结论:
- 跨学科的方法是管理心血管健康在ESLD患者经历LT. 管理必不可少的多学科方法.
- 标准化的手术前方案,精确的风险分层和基于证据的术后监测对于减少心血管疾病并发症至关重要.
- 未来的研究应该专注于优化干预措施,制定共识指导方针,并改善LT接受者的长期心血管护理.
更多相关视频
相关概念视频
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
34
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
34
01:16Kidney Transplant III: Nursing Management
88
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
88
01:23Peripheral Artery Disease V: Postoperative Nursing Management
28
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
28
01:28Esophageal Varices-II: Clinical Features and Management
154
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
154
01:26Kidney Transplant II: Surgical Procedure
78
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
78
01:22Aneurysm IV: Nursing Management
23
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
23