Pathophysiology Department, School of Medicine, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay.
Postoperative Cardiac Critical Care Unit, Centro Cardiológico Americano, Montevideo, Uruguay.
Biomed Res Int. 2017;2017:8217105. doi: 10.1155/2017/8217105. Epub 2017 Oct 19.
The role of the left ventricle in ICU patients with circulatory shock has long been considered. However, acute right ventricle (RV) dysfunction causes and aggravates many common critical diseases (acute respiratory distress syndrome, pulmonary embolism, acute myocardial infarction, and postoperative cardiac surgery). Several supportive therapies, including mechanical ventilation and fluid management, can make RV dysfunction worse, potentially exacerbating shock. We briefly review the epidemiology, pathophysiology, diagnosis, and recommendations to guide management of acute RV dysfunction in ICU patients. Our aim is to clarify the complex effects of mechanical ventilation, fluid therapy, vasoactive drug infusions, and other therapies to resuscitate the critical patient optimally.
长期以来,人们一直关注左心室在 ICU 循环性休克患者中的作用。然而,急性右心室(RV)功能障碍会导致并加重许多常见的危重病(急性呼吸窘迫综合征、肺栓塞、急性心肌梗死和心脏手术后)。一些支持性治疗,包括机械通气和液体管理,会使 RV 功能障碍恶化,可能使休克加重。我们简要回顾了 ICU 患者急性 RV 功能障碍的流行病学、病理生理学、诊断和治疗建议,以指导管理。我们的目的是阐明机械通气、液体治疗、血管活性药物输注和其他治疗方法对危重症患者复苏的复杂影响,以实现最佳复苏。