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心肺体外循环的新进展

What's New in Cardiopulmonary Bypass.

机构信息

Department of Anesthesiology, College of Medicine, University of Kentucky, Lexington, KY.

出版信息

J Cardiothorac Vasc Anesth. 2019 Aug;33(8):2296-2326. doi: 10.1053/j.jvca.2019.01.039. Epub 2019 Jan 16.

Abstract

This is a narrative review of recent articles (mainly published in 2017 and 2018) related to the conduct of cardiopulmonary bypass (CPB) that should be of interest to the cardiac anesthesiologist. Some of the topics covered include recent guidelines on temperature management, anticoagulation, perfusion practice, use of transesophageal echocardiography during CPB, optimal mean arterial pressure, vasoplegia, bleeding, perioperative anemia, post-cardiac surgery transfusion, acute kidney injury, delirium and cognitive decline, CPB during pregnancy, lung management, radial-to-femoral artery pressure gradients during CPB, prophylactic perioperative intra-aortic balloon pump, del Nido cardioplegia, antibiotic prophylaxis, and use of levosimendan in cardiac surgery. The review concludes with a perspective on the effect of these development on the practice of cardiac anesthesia.

摘要

这是一篇对近期与体外循环(CPB)相关的文章(主要发表于 2017 年和 2018 年)的综述,对心脏麻醉师应该具有一定的参考价值。涵盖的一些主题包括最近关于体温管理、抗凝、灌注实践、CPB 期间经食管超声心动图的使用、最佳平均动脉压、血管麻痹、出血、围手术期贫血、术后输血、急性肾损伤、谵妄和认知功能下降、CPB 期间妊娠、肺管理、CPB 期间桡动脉至股动脉压力梯度、预防性围手术期主动脉内球囊泵、Del Nido 心脏停搏液、抗生素预防以及心脏手术中左西孟旦的应用等方面的最新指南。本文最后对这些进展对心脏麻醉实践的影响进行了展望。

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