撤离Impella装置及Impella患者的活动
Weaning from Impella and mobilization of Impella patients.
作者信息
Bertoldi Letizia Fausta, Montisci Andrea, Delmas Clement, Pappalardo Federico
机构信息
Cardio Center, Humanitas Clinical and Research Hospital-IRCCS, via Manzoni 56, 20089 Rozzano (MI), Italy.
Department of Anesthesia and Intensive Care, Cardiothoracic Center, Istituto Clinico Sant'Ambrogio, Via Luigi Giuseppe Faravelli, 16, 20149 Milano, Italy.
出版信息
Eur Heart J Suppl. 2021 Mar 27;23(Suppl A):A41-A45. doi: 10.1093/eurheartj/suab008. eCollection 2021 Mar.
Abstract
Weaning of patients from Impella is complex and includes evaluation of the underlying disease, which is essential for estimating the potential for heart recovery. Monitoring during the weaning phase with echocardiography and pulmonary artery catheters will be discussed, as well as the use of intravenous and oral heart failure drugs. Patients who are candidates for weaning must be stable, without inotropes, and must have recovered from acute end-organ damage. Coronary artery disease and valvular heart diseases should be appropriately addressed before weaning to take the maximum advantage of haemodynamic stability provided by the support and to maximize the possibility of weaning. Tips and tricks for the mobilization of Impella patients will also be discussed.
摘要
让患者撤离Impella装置的过程很复杂，包括对基础疾病的评估，这对于估计心脏恢复的潜力至关重要。本文将讨论在撤离阶段使用超声心动图和肺动脉导管进行监测，以及静脉和口服心力衰竭药物的使用。适合撤离的患者必须病情稳定，无需使用血管活性药物，且必须已从急性终末器官损伤中恢复。在撤离前应适当处理冠状动脉疾病和瓣膜性心脏病，以充分利用该装置支持所提供的血流动力学稳定性，并最大程度地提高撤离的可能性。本文还将讨论Impella患者活动的技巧和窍门。
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