肺动脉高压患者的重症监护管理。
Critical Care Management of the Patient with Pulmonary Hypertension.
机构信息
Department of Medicine, Brown University, 593 Eddy Street, POB Suite 224, Providence, RI 02903, USA.
Department of Medicine, Brown University, 593 Eddy Street, POB Suite 224, Providence, RI 02903, USA; Department of Health Services, Policy, and Practice, Brown University, 593 Eddy Street, POB Suite 224, Providence, RI 02903, USA.
出版信息
Clin Chest Med. 2021 Mar;42(1):155-165. doi: 10.1016/j.ccm.2020.11.009.
Pulmonary hypertension patients admitted to the intensive care unit have high mortality, and right ventricular failure typically is implicated as cause of or contributor to death. Initial care of critically ill pulmonary hypertension patients includes recognition of right ventricular failure, appropriate monitoring, and identification and treatment of any inciting cause. Management centers around optimization of cardiac function, with a multipronged approach aimed at reversing the pathophysiology of right ventricular failure. For patients who remain critically ill or in shock despite medical optimization, mechanical circulatory support can be used as a bridge to recovery or lung transplantation.
肺动脉高压患者入住重症监护病房的死亡率较高，右心衰竭通常被认为是死亡的原因或促成因素。重症肺动脉高压患者的初步治疗包括识别右心衰竭、适当监测以及确定和治疗任何引发因素。治疗的重点是优化心功能，采用多管齐下的方法来逆转右心衰竭的病理生理学。对于尽管经过了最佳药物治疗但仍处于危重或休克状态的患者，可以使用机械循环支持作为恢复或肺移植的桥梁。
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