Heinroth K M
Klinik für Innere Medizin III, Universitätsklinikum Halle (Saale), Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06097, Halle, Deutschland.
Med Klin Intensivmed Notfmed. 2012 Jun;107(5):377-83. doi: 10.1007/s00063-012-0083-4. Epub 2012 May 4.
The management of intensive care patients with implanted devices requires the knowledge of the type of device (e.g. pacemaker, defibrillator, device for cardiac contractility modulation or event recorder). An electrocardiogram (ECG) and chest-X-ray can be helpful for identification of the type and manufacturer of the device. Information concerning the programmed parameters can be obtained by device interrogation. The establishment of invasive monitoring can be complicated by the intracardiac electrodes of the devices and requires a careful selection of the venous access site. In cases of external cardioversion/defibrillation there are some specific considerations to be made to avoid damage of the implanted device. Finally, adaption of device programming to the special circumstances in the intensive care unit may help patient and physician.
对植入式设备的重症监护患者进行管理需要了解设备类型(如起搏器、除颤器、心脏收缩力调制装置或事件记录仪)。心电图(ECG)和胸部X光有助于识别设备的类型和制造商。通过设备询问可获取有关程控参数的信息。设备的心内电极可能会使有创监测的建立变得复杂,这需要仔细选择静脉穿刺部位。在进行体外心脏复律/除颤时,需要考虑一些特殊因素以避免损坏植入式设备。最后,根据重症监护病房的特殊情况调整设备程控可能对患者和医生都有帮助。