Klein E, Uretizky G, Davidson J T, Borman J B
Isr J Med Sci. 1977 Dec;13(12):1211-6.
Immediate emergency surgery is the accepted treatment of intractable pulmonary edema due to valvular heart disease. The presence of severe tissue hypoxia, acidosis, low cardiac output state and renal insufficiency results in a high operative risk. Delay of operation by several hours may prove advantageous in that it permits improvements of the patient's condition by means of intermittent positive pressure respiration with correction of acidosis and at the same time allows for treatment of the cardiac failure. Three illustrative cases are presented, all successfully managed by preoperative treatment in an intensive care unit. The pathophysiological basis of this therapeutic approach is discussed.
急诊手术是治疗瓣膜性心脏病所致顽固性肺水肿的公认方法。严重组织缺氧、酸中毒、低心排血量状态及肾功能不全的存在导致手术风险很高。手术延迟数小时可能是有利的，因为这可以通过间歇正压通气纠正酸中毒来改善患者状况，同时也能治疗心力衰竭。本文介绍了三个典型病例，均在重症监护病房通过术前治疗成功处理。并讨论了这种治疗方法的病理生理基础。
