心脏移植患者的血管麻痹综合征
Vasoplegic syndrome in patients undergoing heart transplantation.
作者信息
Qin Tong-Xin, Yao Yun-Tai
机构信息
Department of Anesthesiology, Shanxian Central Hospital, Heze, China.
Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
出版信息
Front Surg. 2023 Feb 13;10:1114438. doi: 10.3389/fsurg.2023.1114438. eCollection 2023.
OBJECTIVES
To summarize the risk factors, onset time, and treatment of vasoplegic syndrome in patients undergoing heart transplantation.
METHODS
The PubMed, OVID, CNKI, VIP, and WANFANG databases were searched using the terms "vasoplegic syndrome," "vasoplegia," "vasodilatory shock," and "heart transplant*," to identify eligible studies. Data on patient characteristics, vasoplegic syndrome manifestation, perioperative management, and clinical outcomes were extracted and analyzed.
RESULTS
Nine studies enrolling 12 patients (aged from 7 to 69 years) were included. Nine (75%) patients had nonischemic cardiomyopathy, and three (25%) patients had ischemic cardiomyopathy. The onset time of vasoplegic syndrome varied from intraoperatively to 2 weeks postoperatively. Nine (75%) patients developed various complications. All patients were insensitive to vasoactive agents.
CONCLUSIONS
Vasoplegic syndrome can occur at any time during the perioperative period of heart tranplantation, especially after the discontinuation of bypass. Methylene blue, angiotensin II, ascorbic acid, and hydroxocobalamin have been used to treat refractory vasoplegic syndrome.
目的
总结心脏移植患者血管麻痹综合征的危险因素、发病时间及治疗方法。
方法
使用“血管麻痹综合征”“血管麻痹”“血管扩张性休克”和“心脏移植*”等检索词在PubMed、OVID、中国知网、维普和万方数据库中进行检索，以确定符合条件的研究。提取并分析患者特征、血管麻痹综合征表现、围手术期管理及临床结局等数据。
结果
纳入9项研究，共12例患者（年龄7至69岁）。9例（75%）患者患有非缺血性心肌病，3例（25%）患者患有缺血性心肌病。血管麻痹综合征的发病时间从术中到术后2周不等。9例（75%）患者出现了各种并发症。所有患者对血管活性药物均不敏感。
结论
血管麻痹综合征可发生在心脏移植围手术期的任何时间，尤其是在体外循环停止后。亚甲蓝、血管紧张素II、维生素C和羟钴胺已被用于治疗难治性血管麻痹综合征。
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