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心脏手术中的血管麻痹综合征:定义、病理生理学、诊断方法及管理

Vasoplegic syndrome in cardiac surgery: Definitions, pathophysiology, diagnostic approach and management.

作者信息

Orozco Vinasco D M, Triana Schoonewolff C A, Orozco Vinasco A C

机构信息

Departamento de Anestesia cardiovascular, Clínica Colsubsidio Calle 100, Instituto del Corazón de Bucaramanga sede Bogotá, Bogotá, Colombia.

Departamento de Anestesia cardiovascular, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia.

出版信息

Rev Esp Anestesiol Reanim (Engl Ed). 2019 May;66(5):277-287. doi: 10.1016/j.redar.2018.12.011. Epub 2019 Feb 5.

Abstract

Vasoplegic syndrome is a state of vasopressor resistant systemic vasodilation in the presence of a normal cardiac output. Its definition, pathophysiology, risk factors, diagnosis and therapeutic approach will be reviewed in this paper. It occurs frequently during cardiac surgery and is associated with high morbidity and mortality. A search in the LILACS, MEDLINE, and GOOGLE SCHOLAR databases was conducted to find the most relevant papers during the last 18 years. Prompt identification and diagnosis of patients at risk must be undertaken in order to implement an optimal therapeutic approach. This latter includes early treatment with vasopressors with different mechanisms of action.

摘要

血管麻痹综合征是一种在心脏输出正常情况下出现的对血管升压药耐药的全身性血管扩张状态。本文将对其定义、病理生理学、危险因素、诊断及治疗方法进行综述。它在心脏手术期间频繁发生,并与高发病率和死亡率相关。我们在拉丁美洲和加勒比地区卫生科学数据库(LILACS)、医学文献数据库(MEDLINE)和谷歌学术数据库中进行了检索,以查找过去18年中最相关的论文。必须对有风险的患者进行及时识别和诊断,以便实施最佳治疗方法。后者包括使用具有不同作用机制的血管升压药进行早期治疗。

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