Charron Cyril, Belliard Guillaume, Vieillard-Baron Antoine
Réanimation Médicale, Hôpital Ambroise-Paré, 92100 Boulogne-Billancourt.
Rev Prat. 2006 Apr 30;56(8):841-8.
To treat circulatory failures and recognize their mechanisms, we need to understand circulatory physiology. What determines systemic venous return? How does the right ventricle feed the pulmonary circulation? Where is the left ventricular preload reserve located? Four types of circulatory failure are conventionally recognized: hypovolemic, obstructive, vasoplegic and cardiogenic. One or more of these mechanisms may account for circulatory failure in septic shock. Treatment of circulatory failure requires admission to a specialized unit and continuous or discontinuous hemodynamic monitoring. Prognosis is highly dependent on rapid treatment and correction of circulatory impairment.
为了治疗循环衰竭并认识其机制,我们需要了解循环生理学。是什么决定了体循环静脉回流?右心室如何为肺循环供血?左心室前负荷储备位于何处?传统上公认有四种类型的循环衰竭:低血容量性、梗阻性、血管麻痹性和心源性。这些机制中的一种或多种可能是感染性休克循环衰竭的原因。循环衰竭的治疗需要入住专科病房并进行连续或间断的血流动力学监测。预后在很大程度上取决于对循环障碍的快速治疗和纠正。