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新型冠状病毒肺炎感染所致急性右心室衰竭:病例系列

Acute right ventricular failure in COVID-19 infection: A case series.

作者信息

García-Cruz Edgar, Manzur-Sandoval Daniel, Baeza-Herrera Luis Augusto, Díaz-Méndez Arturo, López-Zamora Adán, González-Ruiz Francisco, Ramos-Enríquez Ángel, Melano-Carranza Efrén, Rojas-Velasco Gustavo, Álvarez-Álvarez Rolando Joel, Baranda-Tovar Francisco Martín

机构信息

Cardiovascular Critical Care Unit, Instituto Nacional de Cardiología Ignacio Chávez, Juan Badiano 1, Sección XVI, PO. 14080, Tlalpan, Mexico City, Mexico.

Surgical and Medical Specialties Direction, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.

出版信息

J Cardiol Cases. 2021 Jul;24(1):45-48. doi: 10.1016/j.jccase.2021.01.001. Epub 2021 Jan 18.

Abstract

Severe forms of COVID-19 infection are associated with the need for invasive mechanical ventilation and thromboembolic complications; those can affect the cardiac function especially the right ventricle performance. Critical care echocardiography has rapidly evolved as the election technique in the evaluation of the critically ill patients. This technique has the advantage that it can be done at patient´s bedside and helps to provide the appropriate treatment and to monitoring maneuver's response. We present 4 patients with a confirmed COVID-19 infection who presented with sudden hemodynamic and / or respiratory deterioration, in which transthoracic echocardiogram showed acute right ventricular failure as the trigger for the event and helped to guide an early therapeutic intervention. < Routine echocardiographic evaluation must be mandatory in patients with COVID-19 infection. The presence of refractory hypoxemia and/or hypotension should raise the suspicion of right ventricle failure and must be evaluated with transthoracic echocardiogram. In the clinical scenario of acute right ventricular failure, rising D-dimer and suspected pulmonary embolism, thrombolysis must be considered even without tomographic confirmation.>.

摘要

重症新型冠状病毒肺炎(COVID-19)感染与有创机械通气需求及血栓栓塞并发症相关;这些情况会影响心脏功能,尤其是右心室功能。重症超声心动图已迅速发展成为评估危重症患者的首选技术。该技术的优势在于可在患者床边进行,有助于提供恰当治疗并监测操作反应。我们报告4例确诊COVID-19感染患者,他们出现了突然的血流动力学和/或呼吸功能恶化,经胸超声心动图显示急性右心室衰竭是该事件的触发因素,并有助于指导早期治疗干预。<对于COVID-19感染患者,必须进行常规超声心动图评估。难治性低氧血症和/或低血压的存在应引起对右心室衰竭的怀疑,必须行经胸超声心动图评估。在急性右心室衰竭、D-二聚体升高且怀疑肺栓塞的临床情况下,即使没有断层扫描证实,也必须考虑溶栓治疗。>

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/331a/8258263/290bc57797a6/gr1.jpg

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