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计划接受手术的心脏植入式电子设备患者的麻醉考量

Anaesthetic consideration in patients with cardiac implantable electronic devices scheduled for surgery.

作者信息

Chakravarthy Murali, Prabhakumar Dattatreya, George Antony

机构信息

Department of Anesthesia, Critical Care and Pain Relief, Fortis Hospitals, Bengaluru, Karnataka, India.

出版信息

Indian J Anaesth. 2017 Sep;61(9):736-743. doi: 10.4103/ija.IJA_346_17.

Abstract

With advances in cardiology and cardiothoracic surgery, several newer implantable cardiac devices have become common in the surgical population. Multichamber pacemakers, implanted cardiac defibrillators and ventricular assist devices are frequent in current day practice. Many of the newer implantable cardiac electronic devices are targeted at managing heart failure. While managing such patients for non-cardiac surgeries, specific issues related to equipment characteristics and troubleshooting should be a priority for the anaesthesiologists. There is a possibility of malfunction of the devices resulting in catastrophic outcomes. Therefore, it is imperative to understand the pathophysiology, device characteristics and troubleshooting before embarking on anaesthetising patients with implantable cardiac electronic devices.

摘要

随着心脏病学和心胸外科手术的进展,几种更新的植入式心脏设备在外科手术人群中已变得很常见。多腔起搏器、植入式心脏除颤器和心室辅助装置在当今的临床实践中很常见。许多更新的植入式心脏电子设备旨在治疗心力衰竭。在为这类患者进行非心脏手术时,与设备特性和故障排除相关的特定问题应是麻醉医生的首要关注点。设备有可能发生故障,从而导致灾难性后果。因此,在着手为植入心脏电子设备的患者实施麻醉之前,了解其病理生理学、设备特性及故障排除方法是至关重要的。

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