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超声心动图与心脏创伤的处理。

Echocardiography and Management for Cardiac Trauma.

机构信息

Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY; Paris Simulation Center, Office of Medical Education, University of Louisville School of Medicine, Louisville, KY; Outcomes Research Consortium, Cleveland, OH.

Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY.

出版信息

J Cardiothorac Vasc Anesth. 2022 Aug;36(8 Pt B):3265-3277. doi: 10.1053/j.jvca.2022.02.010. Epub 2022 Feb 12.

Abstract

Trauma is the number one cause of death among Americans between the ages of 1 and 46, costing >$670 billion a year. Blunt and penetrating trauma can lead to cardiac and aortic injuries, with the incidence of death varying upon the location of the damage. Among those who reach the hospital alive, many may survive if the hemorrhage and cardiovascular injuries are diagnosed and treated adequately in a timely fashion. Although echocardiography often is underused in the setting of cardiac trauma, it offers significant diagnosis and treatment potential because it is accessible in most settings, safe, relatively noninvasive, and can provide rapid and accurate trauma assessment in the hands of trained providers. This review article aims to analyze the pathophysiology of cardiac injuries in patients with trauma and the role of echocardiography for the accurate diagnosis of cardiac injury in trauma. This review, additionally, will offer a patient-centered, team-based, early management plan with a treatment algorithm to help improve the quality of care among these patients with cardiac trauma.

摘要

创伤是 1 至 46 岁美国人死亡的首要原因,每年造成的损失超过 6700 亿美元。钝性和穿透性创伤可导致心脏和主动脉损伤,其死亡率取决于损伤部位。在那些活着到达医院的人中,如果及时充分地诊断和治疗出血和心血管损伤,许多人可能会存活下来。尽管超声心动图在心脏创伤的情况下常常使用不足,但它具有重要的诊断和治疗潜力,因为它在大多数情况下都可以获得,安全、相对无创,并可在经过培训的医务人员手中提供快速准确的创伤评估。本文旨在分析创伤患者心脏损伤的病理生理学以及超声心动图在准确诊断创伤性心脏损伤中的作用。此外,本综述将提供一个以患者为中心、基于团队的早期管理计划和治疗算法,以帮助改善这些心脏创伤患者的护理质量。

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