在内动脉瘤剪切过程中,在异步步调的患者中给予高剂量腺素:一个病例报告
Anna C St Denis1, Hayden B Jefferies2
1From the Department of Anesthesiology, Critical Care and Pain Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas.
A&A practice
|March 4, 2026
概括
腺素可以在神经外科手术期间有效降低血压,即使在带有起器的患者中也是如此. 重编程设备允许控制低血压,扩大大脑 perfusion 管理的选项.
科学领域:
- 心血管医学 心血管医学
- 神经外科 神经外科
- 麻醉学 麻醉学
背景情况:
- 在脑血管手术期间,管理大脑输液压力至关重要.
- 患有高心室节奏负担的患者对诱导的低血压构成独特的挑战.
- 心脏再同步治疗与除器 (CRT-D) 装置复杂化了使用腺来诱导静脉失速.
研究的目的:
- 为了评估腺对受控低血压的疗效,在接受脑动脉瘤剪切的CRT-D装置患者中.
- 为了确定腺是否可以诱导可预测的低血压,尽管连续的心室节奏.
主要方法:
- 患者的CRT-D装置被重新编程为双步,没有感觉,没有响应 (DOO) 模式,除功能被禁用.
- 在大脑动脉瘤剪切手术期间,给予了腺素玻尿素.
- 监测血液动力学反应,特别是血压.
主要成果:
- 腺素的使用导致了可预测的低血压.
- 尽管保持不间断的心室节奏,但仍能达到低血压.
- 这种技术被证明对临时的大脑流量控制有效.
结论:
- 腺素可以在持续节奏患者中作为安全有效的低血压剂.
- 设备重编程为复杂的神经外科病例中利用腺提供了一种可行的策略.
- 这种方法扩大了在脑血管外科手术期间管理大脑输液压力的武器库.
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