Duncan Chris F, Bowcock Emma, Pathan Faraz, Orde Sam R
Department of Intensive Care Medicine, Nepean Hospital, Kingswood, Sydney, NSW, 2747, Australia.
Department of Cardiology, Nepean Hospital, Kingswood, Sydney, NSW, 2747, Australia.
Ann Intensive Care. 2023 Aug 2;13(1):67. doi: 10.1186/s13613-023-01163-4.
Mitral regurgitation (MR) is common in the critically unwell and encompasses a heterogenous group of conditions with diverging therapeutic strategies. MR may present acutely with haemodynamic instability or more insidiously with failure to wean from mechanical ventilation. Critical illness is associated with marked physiological stress and haemodynamic changes that dynamically influence the severity and implication of MR. The expanding role of critical care echocardiography uniquely positions the intensivist to apply advanced bedside valvular assessment to recognise haemodynanically significant MR, manipulate and optimise cardiopulmonary physiology and identify patients requiring urgent cardiology and surgical referral. This review will consider common clinical scenarios, therapeutic strategies and the pearls and pitfalls of echocardiographic assessment and quantification in the critically unwell.
二尖瓣反流（MR）在危重症患者中很常见，涵盖了一组治疗策略各异的异质性疾病。MR可能急性出现血流动力学不稳定，或更隐匿地表现为无法脱离机械通气。危重病与显著的生理应激和血流动力学变化相关，这些变化会动态影响MR的严重程度和影响。重症监护超声心动图作用的不断扩大，使重症监护医生能够独特地应用先进的床旁瓣膜评估，以识别血流动力学上显著的MR，控制和优化心肺生理功能，并识别需要紧急心内科和外科会诊的患者。本综述将探讨危重症患者常见的临床情况、治疗策略以及超声心动图评估和量化的要点与陷阱。
