机械循环支持与高危急性肺栓塞的重症监护管理。
Mechanical Circulatory Support and Critical Care Management of High-Risk Acute Pulmonary Embolism.
机构信息
University of Michigan Department of Internal Medicine, 1500 East Medical Center Drive, 3116 Taubman Center, SPC 5368, Ann Arbor, MI 48109-5368, USA.
Cleveland Clinic Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, 9500 Euclid Avenue, Mail Code J3-4, Cleveland, OH 44195, USA.
出版信息
Interv Cardiol Clin. 2023 Jul;12(3):323-338. doi: 10.1016/j.iccl.2023.03.004. Epub 2023 Apr 27.
Abstract
Hemodynamically significant pulmonary embolism (PE) remains a widely prevalent, underdiagnosed condition associated with mortality rates as high as 30%. The main driver of poor outcomes is acute right ventricular failure that remains clinically challenging to diagnose and requires critical care management. Treatment of high-risk (or massive) acute PE has traditionally included systemic anticoagulation and thrombolysis. Mechanical circulatory support, including both percutaneous and surgical approaches, are emerging as treatment options for refractory shock due to acute right ventricular failure in the setting of high-risk acute pulmonary embolism.
摘要
血流动力学意义重大的肺栓塞（PE）仍然是一种广泛存在、诊断不足的疾病，其死亡率高达 30%。导致不良预后的主要原因是急性右心衰竭，这种情况在临床上难以诊断，需要重症监护管理。高危（或大面积）急性 PE 的传统治疗方法包括全身抗凝和溶栓。机械循环支持，包括经皮和手术方法，正在成为高危急性肺栓塞导致急性右心衰竭伴难治性休克的治疗选择。
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