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非ST段抬高型心肌梗死(NSTEMI)后合并严重脓毒症和心源性休克患者的死亡预防措施:一例报告

Steps To Prevent Mortality in a Patient with Coinciding Severe Sepsis and Cardiogenic Shock Post-Non-ST-Elevation Myocardial Infarction (NSTEMI): A Case Report.

作者信息

Nagaratnam Julius M, Farooq Rubab, El Dirani Mirna, Mathew Shaun, Ogwu Celestine I, Kholoki Samer

机构信息

Internal Medicine, Avalon University School of Medicine, Chicago, USA.

Internal Medicine, Saint James School of Medicine, Chicago, USA.

出版信息

Cureus. 2022 Nov 30;14(11):e32086. doi: 10.7759/cureus.32086. eCollection 2022 Nov.

Abstract

Severe sepsis is characterized by acute organ dysfunction secondary to an infective source, often requiring emergent medical intervention. The severity of sepsis is determined by a criterion that focuses on the presence of fever, tachycardia, tachypnea, leukocytosis, lactic acidosis, hypotension, evidence of organ failure, and the presence of an infective source. Management of sepsis in patients with a coinciding ischemic event such as a myocardial infarction (MI), is difficult, given the prognosis is poor and there is a high risk for mortality. This case report explores methodical medical measures taken to prevent mortality in an 81-year-old Hispanic male that developed severe sepsis in conjunction with a complicated presentation of a non-ST-elevation myocardial infarction (NSTEMI).

摘要

严重脓毒症的特征是继发于感染源的急性器官功能障碍,通常需要紧急医疗干预。脓毒症的严重程度由一个标准来判定,该标准侧重于发热、心动过速、呼吸急促、白细胞增多、乳酸酸中毒、低血压、器官衰竭的证据以及感染源的存在。对于伴有心肌梗死(MI)等缺血事件的脓毒症患者,治疗起来很困难,因为预后很差且死亡风险很高。本病例报告探讨了为预防一名81岁西班牙裔男性死亡而采取的有条不紊的医疗措施,该男性同时发生了严重脓毒症并伴有非ST段抬高型心肌梗死(NSTEMI)的复杂表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7314/9803867/abf954837d6a/cureus-0014-00000032086-i01.jpg

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