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重症监护病房环境中的丙泊酚:了解和处理抗心律失常、促心律失常作用及丙泊酚输注综合征

Propofol in ICU Settings: Understanding and Managing Anti-Arrhythmic, Pro-Arrhythmic Effects, and Propofol Infusion Syndrome.

作者信息

Paramsothy Jananthan, Gutlapalli Sai Dheeraj, Ganipineni Vijay Durga Pradeep, Mulango Isabelle, Okorie Ikpechukwu J, Arrey Agbor Divine Besong, Delp Crystal, Apple Hanim, Kheyson Borislav, Nfonoyim Jay, Isber Nidal, Yalamanchili Mallikarjuna

机构信息

Internal Medicine, Richmond University Medical Center Affiliated with Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, Staten Island, USA.

Internal Medicine Clinical Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

出版信息

Cureus. 2023 Jun 15;15(6):e40456. doi: 10.7759/cureus.40456. eCollection 2023 Jun.

Abstract

Propofol has revolutionized anesthesia and intensive care medicine owing to its favorable pharmacokinetic characteristics, fast onset, and short duration of action. This drug has been shown to be remarkably effective in numerous clinical scenarios. In addition, propofol has maintained an overwhelmingly favorable safety profile; however, it has been associated with both antiarrhythmic and proarrhythmic effects. This review concisely summarizes the dual arrhythmic cardiovascular effects of propofol and a rare but serious complication, propofol infusion syndrome (PRIS). We also discuss the need for careful patient evaluation, compliance with recommended infusion rates, and vigilant monitoring.

摘要

丙泊酚因其良好的药代动力学特性、起效迅速和作用时间短,给麻醉和重症监护医学带来了变革。这种药物在众多临床场景中已被证明具有显著疗效。此外,丙泊酚一直保持着极为良好的安全性;然而,它与抗心律失常和促心律失常作用都有关联。本综述简要总结了丙泊酚的双重心律失常心血管效应以及一种罕见但严重的并发症——丙泊酚输注综合征(PRIS)。我们还讨论了对患者进行仔细评估、遵守推荐输注速率以及进行 vigilant 监测的必要性。 (注:vigilant 常见释义为“警惕的”,这里结合语境似为“严密的”,但原英文表述有误,正确应该是“vigilant monitoring”,直译为“警惕的监测”,意译为“严密监测” )

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12a3/10349530/3af5c8da1b8d/cureus-0015-00000040456-i01.jpg

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