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变化斑点跟踪心声学下降胸前大动脉的值与上升的阳性末呼吸压力水平的变化

María Belén Martínez-Lechuga¹, Javier Hidalgo-Martín², José Ángel Ramos Cuadra³

¹University Jaén Hospital, 23007 Jaén, Spain.

Medicina (Kaunas, Lithuania)

|October 29, 2025

概括

阳性末尾呼气压 (PEEP) 在机械通风 (MV) 时发生心脏性休克 (CS) 的患者中显著改变下降胸前大动脉 (DTA) 斑点跟踪值. DTA旋转移位可能预测CS患者的死亡率.

科学领域:

心脏病学心脏病学
临界护理医学临界护理医学
医疗成像医学成像

背景情况:

心脏性休克 (CS) 是一种需要机械通风 (MV) 的严重疾病.
阳性末尾呼气压 (PEEP) 是一种常见的MV设置,具有潜在的血液动力学影响.
在CS患者中,PEEP对下降胸前大动脉 (DTA) 的影响尚不清楚.

研究的目的:

为了评估DTA斑点跟踪速度向量分析 (VVI) 值在不同PEEP水平下的变化,在MV的CS患者中评估变化.
评估DTA斑点跟踪参数与CS患者死亡率之间的关联.
使用健康个体的对照组建立正常的DTA变量.

主要方法:

用DTA斑点跟踪进行的跨胸腔心声扫描 (TTE) 在MV的62名CS患者中进行.
PEEP水平逐渐从0增加到15cmH2O.
分析包括DTA速度,位移,应变 (S) 和应变率 (SR),以及用于死亡率预测的后勤回归.

主要成果:

PEEP显著影响了DTA斑点跟踪参数,通常在5cmH2O PEEP时观察到峰值值.
在PEEP水平之间,在DTA旋转速度,辐射速度,旋转位移,周围应变和周围应变率上注意到了显著的变化 (p<0.05).
左心室应变和DTA旋转位移在5cmH2OPEEP时与患者死亡率有关.

结论:

显然,PEEP水平对机械通风的CS患者的DTA斑点跟踪测量有影响.
斑点跟踪是评估胸前动脉的一种可行的方法.
DTA旋转位移可以作为心脏性休克的预后指标.

关键词:

对于PEEP来说,这是一个很好的方法.大动脉的动脉.心脏发生的冲击是心脏发生的冲击.斑点跟踪跟踪斑点跟踪

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