Troiano Nan H
Nan H. Troiano is a Consultant, Perinatal Nursing, High Risk and Critical Care Obstetrics, PO Box 465, Arley, AL 35541 (
AACN Adv Crit Care. 2018 Fall;29(3):273-283. doi: 10.4037/aacnacc2018911.
Substantial physiologic changes accompany pregnancy, the most profound of which involve the cardiovascular system. These changes affect maternal hemodynamic and oxygen transport status. This article describes cardiovascular changes that occur during pregnancy including blood volume, heart rate, stroke volume, cardiac output, vascular resistance, and colloid osmotic pressure. Alterations in factors related to maternal oxygen transport including oxygen affinity, delivery, and consumption also are described. Concepts related to fetal oxygen transport and adaptive responses to hypoxemia are presented. Technical considerations regarding assessment of maternal hemodynamic and oxygen transport status during pregnancy are described and assessment findings during labor, birth, and the immediate postpartum period are interpreted. A maternal hemodynamic and oxygen transport profile is presented to illustrate these principles in clinical practice.
妊娠伴随着大量生理变化，其中最显著的变化涉及心血管系统。这些变化会影响母体的血流动力学和氧运输状态。本文描述了妊娠期间发生的心血管变化，包括血容量、心率、每搏输出量、心输出量、血管阻力和胶体渗透压。还描述了与母体氧运输相关的因素的变化，包括氧亲和力、输送和消耗。介绍了与胎儿氧运输和对低氧血症的适应性反应相关的概念。描述了妊娠期间评估母体血流动力学和氧运输状态的技术注意事项，并解释了分娩、出生和产后即刻的评估结果。给出了母体血流动力学和氧运输概况，以说明这些原则在临床实践中的应用。
